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t� ryrC Miami Shores Village v� 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 y Phone: (305)795 -2204 Type of Work: Re -Roof Additional Info: Classification: Residential Fees Due Permit No. RF-4- 07-832 at Per Permit Type: Roof ml Work Classification: Roof - New Permit Fee - New Roof Permit Status: APPROVED Issue 'Date: 4127/2007 Expiration: 10/2412007 Type of Work: Re -Roof Additional Info: Classification: Residential Fees Due Amount CCF $13.20 Education Surcharge $4.40 Permit Fee - New Roof $300.00 Scanning Fee $12.00 Technology Fee $7.50 Total: $337.10 Valuation: $ 22,000.00 Total Sq Feet: 3000 Total Amt Paid Amt Due ................. _ _..._....._...._...... $ 0.00 $ 0.00 $ 0.00 Payment Type: MAY 0 2 PAID fwaaaoie mspecuons: Inspection Type: Final Roof Hot Mop Tile In Progress Up Lift Report In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhemtore, I authorize the above -named contractor to do the work stated. April 27, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Friday, April 27, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)766-8972 . . . . . . . . . . . ....... Inspection Date: 06/18/2007 Permit Type: Roof Inspector: Grande, Claudio Inspection Type: Final Roof Owner: KROBOTH, PETRONELLA Work Classification: Roof - New Job Address: 257 103 Street NE Miami Shores, FL 33138-2430 Phone Number Parcel Number Project: <NONE> Block: Lot: 1121360130420 Contractor: JOHN BUSTA ROOFING INC Phone: (306)757-7620 Buildina Department Comments RE ROOF SLOPE AND FLAT ROOFS.FLAT TILE OFF AND FLAT COLOR THRU TILE BACK ON JUN 19 2007 Passed IV Inspector Comments Failed Correction Needed Re-Inspection Fee ($76) No Additional Inspections can be scheduled until re-inspection fee is paid . Friday, June 15, 2007 Page 1 of 2 .[.a!M • moo+. -r vr.•..� -�e��a � ALLEY LEGAI e 1-01 , E Y2. m , i3l♦OGK. -i19 M1AM1 9HoRES A � ICA at z PA-n v x sxS' i 1 I— CK /ST! N 6-- +� x Q>i477 0 � �X♦L � t I � Cowc2� 9L I 1 . u' �CAU i1 f SEPVC TA" I 51'-4 _r s /O -G• - TAJ 7_. 6 tA c�C� N I Issued - Amount �c r No. Houses KNOW ALL MEN BY aiami cfhores'—_Xll age F L O B I D A BUILDER'S BOND PRESENTS, that T_ ;a N® 783 in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construct or repair a building or buildings at the following addresses: -0 a do hereby deposit with Miami Shores Village, Florida, the sum of qr ea t , and I agree with said Village that, when such construction shall have been__�ompl =eted 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- e construction or repair an I coo not -so- clear and -Tepah teach premises °immediately-upow -the comQletion-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 immediately, as aforesaid,- then said shall be returned to me. WITNESS MY HAND and Seal at Miami Shores Village, Florida, this ay of P (Seal) INSTRUCTIONS TO BUILDER -When above mentioned construction is completed and the pre s are cleared and repaired take this bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refund y6& money in accordance with the above agreement. VILLAGE BUILDING. INSPECTOR'S APPROVAL I hereby certify that the construction contemplated under this Bond, has been completed and that the builder thereof has caused the surrounding premises to be cleared and repaired in as good condition as they were before commencing said construction. WHEN CLEARED AND REPAIRED BY THE VILLAGE Amount of Bond. . . . . . . . . . . $ _i 0 Building Inspector, Miami Cost of clearing and repairs done by Village . . $ Balance due Builder . . . . . . . . . . $ Cancelled 19 MIAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMENT APPLICATID F'OR BW tLDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- or other structure herein described. This application is made in ',compliance and conformity with the Building Ordinance of ' Miami Shores Village, Florida and all provisions of the Laws of the State o Flo -dda�,, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall bey, com Bed with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the wwlork. Date .19� Owner's Name and Address_ = �` _ N(Y - — Street —_, — -__" Registered Architect and /or Engmeer___r= - Name and address of licensed contractor Location.and Icgal.description of lot to be is to be State w rk to c be � ne and ose of 1 wilding (by .m _ IV A_ .L New Building �_ _— Remodeling_: To be constructed of__ Kind of Estimated Total cost of improvements $ %• Zone cubage 0 Distance to next nearest building___ Maximum live load to be borne by each floor I hereby submit all the plans and specifications be sent to — and for no other purpose. Repairs_---------- No. of Stories— Y _ Amoout of Permit ize of Building Lot — 44'-2 said building. All notices with reference to the building . and its construction may The undersigned applicant, for this building permi does hereb of labor under the Florida Workmen's Compensation ct, being and has complied with the provisions thereof, and wil� require sin in the work to be performed under this permit; and weal post or a or notices as are required by the Act. The undersigned i,!agrees to ei permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, COUNTY OF DADE. # SS. Before me, the undersigned authority, a notary pu peared and who, being by me first duly sworn, upon oath del of the above des ed co truction, that h carefi therein by him sta are Permit No. — _ Date Disapproved'— ( Signed) Building Inspectoi PLANNING BC duly I t&byf that he understands and accepts his obligations as an employer a on 966, Compiled General Laws of Florida, Permanent Supplement, compliance from all contractors or sub- contractors employed by him ;o to be posted for inspection on the site of the work such public notice Ley only such subcontractors, on work to be perform -under this• {Signed) y�orized to administer oaths and take acknowledgments, personally ap- me well known, s and says that he is the------- - - - -_— —_ read t e foregoing application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before nee. Notary Public, State of Florida My Commission Expires D - - —_..DATE Chairman Member Member -_— Member -_ Member Member Council Approved - -,--_ _ __ —Ti Tate I, I, Disapproved - - - -_ -- ___ -- - -Date NOTE: A charge of $1.00 will be made for mal ing correction or changes to this application after approval has been obtained from the Planning Board. a A re- inspection fee of $1.00 will be charged wh n such re- inspeq fon is made necessary- by improper notice for inspection or faulty materials and /or workmanship. y; i MIAMI PHORE� OUILD[Nd INSPECTION APPLICATION FOR�� B!I Application is hereby imade for the approval of th detailed stat4ent L in or other structure herein described. Thus applicati n is made in ,comp, ' Shores Village, Florida, and all provisions of the Law of the State of Fl regulations of the Building Division of Miami Shores 1ge shall be com plans and specifications most be kept at building d g progress of ;the wFc Owners Name and Address_ Registered Architect and /or Engineer tti Name and address of lice 'red contractor_;. Location and legal description of lot to be built on: L Block Subdivision_ Street and Number where work is to be State work to be _done an purpose of building (by loors)� J ----r- VILLAGE DEPARTMENT Y� ILDING PERMIT the plans and specifications herewith submitted for the build - ice and conformity with the Buildingg Ordinance of Miami i, all ordinances of Miami Shores Village and all rules and :d with,, whether' herein specified or not. A copy of approved No._ -� t-) e C--- ' -,,77 d And for no other purpose. New Building Remodeling - --_ Additiou Repairs __ No. of Stories________ To be constructed of Kind of founda l'on -- Roof Covering Estimated Total cost of improvements Amo�t of Permit $ f Zone cubage required Plan Cub. / L , Distance to neat nearest building Size Maximum live load to be !borne by each floor I hereby submit all e plans and specifications for said buildmgdmg. All N be sent to�_.._.�`,' The undersigned applicant for this building permit does hereby cerO of labor under the Flo E Workmen's CompensationIjAct, being S ' ti on and has complied with a provisions thereof, and wil require simiPltr car in the work to be performed under this - permit; and vaill post or cause to 1 . Miami Shores. Village. �� . � � or notices as are required by the Act. The undersigned agrees to em toy permit, as are licensed b� Remarks (� STATE OF FLORIDA, CO UNTY OF DARE ss. lof Building with reference to the building and its construction may that he understands and accepts his obligations as an employer )88, Compiled General Laws of Florida, Permanent Supplement, pli ance from all contractors or sub - contractors employe him 9 posted for inspection on the site of the work such public notice ly such subcontractors, on work to be performed under this t wed) l � it Before me, the undersigned authority, a notary p4lic, duly au orized to adnAnister oaths and take acknowledgments, personally ap- peared ! _ and who, being by me fist duly sworn, upon oath 4poses and sa; of the above described construction, that he has carefully read the therein by him stated are true. I II Permit No. Date Disapproved Date ( Signed ) Building Inspector !, PLANNING B'{OARD ----4-' Chairman Member Member Council Approved—__._1..— NOTE: A charge of $1.00 will be made for the Planning Board. c= A re- mspection fee lof $1.00 will be charged materials and /or workmanship. - me well known, ,t he is the - _ going application, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission F,apires DatQ'i Disapproved -- Date ing corrections or changes to this application after approval has been obtained from )n such re-i ecti� is made necessary by improper notice for inspection or faulty i i MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMITk; Permit No. -_ y 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 lbe complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ___ ,, �� _ __ ._. No. _ Street _. -------- Registered Architect and /or Engineer - -- Employing Plumber's Name, 41 c '� _ No. Location and Legal Description Lot Bloch Subdivision_ Street and Number where wo> is to be performed —No % Street___._. -_. State work to be performeS 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 Drain Field from Well__ n+� Feet of Tank or Nature of Water Su pp y� 1 CC i —Well. _Size of Soakage Pit ___._ ----- � Amount of Permit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligWons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under .this.permit; and will post or cause to be poster]' 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. " E° v� (Sigma) Master Plumber. - - - -_ STATE OF FLORIDA, ( 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 osm 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-neoessaty by improper notice for inspection, or faulty materials and /or worlauanshi . BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS Sf10WER8 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 -I CONTR. T LIST CHECK Size Septic Tank___ Type of Tank - -___ -- _----__Capacity Gals._. _.___.__._.__._.— .._..._._____. Feet of Drain Tile Drain Field from Well__ n+� Feet of Tank or Nature of Water Su pp y� 1 CC i —Well. _Size of Soakage Pit ___._ ----- � Amount of Permit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligWons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under .this.permit; and will post or cause to be poster]' 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. " E° v� (Sigma) Master Plumber. - - - -_ STATE OF FLORIDA, ( 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 osm 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-neoessaty by improper notice for inspection, or faulty materials and /or worlauanshi . wu MIAMI "SWORES VILLAGE PLUMBING INSPECTION DEPARTMENT i APPLICATION FOR PLUMBING PERMIT Permit 1Nr+.------ -- -j 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 ordinance of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shale 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 I, No atze -- Vf Registered Architect and /or Employing Plumber's Name Location and Legal Descripti n Lot Block Subdivision..._ Street and Number where work is to be performed —No- s4% �� ___ _ _ �*t _ _ __ _____ State work to be performed and purpose of building (By Flom)—_ r _ .___.._._- .-- __.__.-- • -. --_ ._. � - - --. New Building_ __-- -:.._— _ Remodeling Addition _ Repairs.._ — ------- --- .-_. No. of Stories ... ......... ........... - BATH SHOWERS LAVA. SLOP SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL C4OSf2'PS TUBS TORIES SINKS TUBS URINALS BASIN DRAIN FOUNT'NS FIXTURES CONTR. LIIET C°.HSCK SEPTIC SEWER !DRAIN .SOAKAGE GREASE' SOLAR DEEP SPRKLR. SWIM'G ` TANK CONN. I F, IELD PIT TRAP HEATER WELL SYSTEM POOL (� LIST CHECK Sim Septic Tank. Type of Tank ___ ___.— Capacity Gals..._- _—_.____...__------- ------------ Feet of Drain Tile Di Feet of Tank or Drain Field from Well___ Nature of Water Supply: Cit� —Well. _Size of Soakage Pit w __ . _ —_ __._____--- _- __......... a Amount of Permit � :L��. -�� (Signed) G PI c ing Inspector. The underfed applic ant for this building permit does hereby certify that he understands and amts his obligations as an employer of labor under the Florida Workmen IsI Compensation Act, being Section 59M, 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 poster)' for inspection on the site of the w k such public notice or notices as are raqwred by the Act The undmsigned agrees to employ only such sub- contractors, on work to performed under this permit, as are licensed Mid Sham Mi Shores Village. (Signed) - - Master Plumber. - STATE OF FLORIDA, ( s COUNTY OF DADE. j Before me, the undersigns 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 oathdeposes and. says that he is . ._...____......._..........._.. of the above described constructlon, 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 Coiiamission Expires Notary Public, State of Florida I NOTE: A re- ingxwUmn fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty matalals and /or worlmoans*. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uinde 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 ..l �._......__._.......... ,19Js_7� Owner's Name and Address., 1... ........./..!.. pie e. 1. ...__..,2�.��!�. ....... »... and /or i e . /_� Q.. e,,.................. Registered Architect hn�.�t. r....., - ......,. ... .. ................ ......... .. ......... -- \'ame and address of licensed contractor . - - - - -1 ��" * __. 771, .... r......... �......1 .......s�.. P... r- z_.... Location and legal description of lot to be built on: / Lot............................................ Block... ......---- ..................... Subdivision ..................... _ ................... _............__ ...... _._ ........... _. ................. ....... Street and Number where work is to be done ........ a .5.1...._.A' gE_..11�1...._S2-, _._.. _ .. ... . State work to be done and purpose of building (by flyers) ..... ----- __......� ............and for no other purpose. New Buil ding ............................ Remodeling ................ ........ Addition....................... Repairs ............... .---- No. of Stories ..... P122.L�...._ To be constructed of .. Kind of foundation ..... ! Sl l..? 2 .. ............................._. �e��s ....._.. _ ....... ................ Estimated Total cost of improvements $,..3 �� ....................... unt of Permit $ ........ ._ ............................ - _..... * ".'_..- ........ Zone cubage required.__ -. .................... - ........ Plan Cubage ........... ....... Distance to next nearest building ------------------------------------------- --------- _ ----- Size of Building Lot.... :Maximum live load to be borne by each floor ... .............................................. _............................. I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent 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, Pennxment 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 performe 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 subco actors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks---- ------------------ - ................................................ ...... - _ __ ( Signed )..... STATE OF FLORIDA, ) COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persorially 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. �r Permit No.._ ... - ........ .___M ------ ----------- Date ....................................... , Read, Sworn to and Subscribed before me. Disapproved + I Date--. .c - - - - -- _ - ._._. . .. _.... ... Noe Public, State of Florida ( Signed) ------ .... ........... ..... . -... .. _ . ... . Building Inspector My Commission Expires ....... .................. _....._.._......_.__ - PLANNING BOARD ...................... .................... _.._ ...... DATE I' Chairman......... ------------------- - ............................... _ ......... .................. Member ............................... ....... ... ........................ -. ....... _.............. Member ............................... --_ Member ....... _..... Member-- - -- - - - --- Member .... ................. ---------------..__. ..__..._--- _.............- --- -- - - - CouncilApproved ............................................. - .._ ....................... Date Disapproved ...... _ ................................................ ......... ................ Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has heen obtained from the Planning hoard. A re- in>pec•tion fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ., BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILOINO PERMIT Applieation is hereby uiade for the approval of the detailed statuim,ni of ine plans and specifications herewith submitted for the build in; or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Villap shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during prpgress of the work. Date ... _........ __... ._._._ ».» _ . »...._l... »... ,19.._._ Owner's Name and Address ............ .. :... :... :.. :.. :.............. /z:..». �.........................__ No...................._ ». Street -1.. :......_................._. Registered Architect and /or Engin l er .......... ............. ....... a, ss......• , ve ............................ tf y9inL / Fameand address of licensed contractor ..................L.L » »....ta .._........: ..... .. ............ »...... »..» ....... ,»_»..-................................._.._..-- Location and legal description of lot to be built on: <r k " Lot... ......................................... Block... ............................... Subdivision.................... _......... ..........»....»._-.._» ...... _._ .......... ._ ................. _ ...... _.. Street and Number where work is to be done.....:...:....: � � State work to be done and purpose of building (by floors) ... »... ..... _.. »�`2` `............................. '.. _� ...._.._ ...._ _...._ ._.._.._ -4 ............. ............... _ ... _ ............... ......... ... ... .... .:' ........_....................... . ..................... _ ........ - ............................................................................._...._..._..__................._.................. ........................._..... ».............and for no other purpose. New Bui! ding ............................ Remodeling................ ........ Addition .......................... Repairs ......................... No. of Stories ...... .f.............. To be constructed of ......................... land of foundation.................. ............................... ......._. Roof Covering................. ' ` ..... Estimated Total cost of improvements 5...........•...::?..2 .. . ............•......••...Amount of Permit 5. ........ _ ........ _ ............................ __ ................... _........ Zonecubage required ..... ............................. .................................. _.._ ....Plan Cubage ................................................................ --- Distance-to next nearest building............. ......................... _ ........ _ ..... Size of Building Lot ...................... _ ..... _ .......... _ ...... ..... ............. _ ........ _ Maximumlive load to be borne by each floor ........................................................................................................................ ............................. .. .... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to.. ... .. ............. ............................................... ............................... .............. The unrlersirned applicant for this building permit does hereby certify that he understands and accepts his obligations n% an employer of I.ibur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennxnent SolVe•ment, anci has complied «ith the t�ruvisions 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 pennit, as are licensed by Miami Shores Village. Remarks (Signed).., STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - - - - -- --------------------- ........ .............. ...... ........................ - .......... -------- --- - ---- -------- .......... _ ....... _ .......... _ .................. _ __.....to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . ........ .......... ................................................................ _........ of the above described construction, that lie has carefully read the foregoing application, and that he did sign the same, and that all fads therein by him stated are true. . _,� ..- 3 1� Y.-( ............ _._ Read, Sworn to and Subscribed before me. Permit No.._.... ... ............ Date...:: .... ... ...... Disapproved........ Ai. Date --- ........ - ......... ----------------- .......... ........................................... .........., ..._._.._...— _..._.., i Notar Public State of Florida (Signed) ........................ ..... ..:: ......................... ............................... Building Inspector My Commission Expires. ...... _ ................. .» ...... ....... — ._ —__.�. PLANNING BOARD ...................... ..................... _.._......DATE Chairman........ .................... .. ............................... _ ......... _................. Member ....... _ ....................... ....... ............................ _ ....... _ .............. _ Member................................ _ ------------------------------- _--- --------------------- --- Member ........ ......................................... ................ ;Member .. .......... .................... ............--- ...__.---- - - - - -. _...._....... Member .... _ ................ ---._.-------------_------ CouncilApproved ................... .............................. _ ....................... Date Disapproved ...... _ .................... ............................. .. ..... ... ............ Date NOTE: A charge of $1.00 will be made for making carrections or changes to this application after approval has been obtained from the Plannio (Board. A rc- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date_ ----------- _ -------- ------------------------ 19_ ---- -- Owner's Name and Address --------------------- 1�_a ------- ------ � - ---------- I --------- --------- ------------- Registered Architect and/or Engineer. -- -- ------ ----------- -- -- --------- ---- -- ------------------------ - ---------- --- - --- ---------- Name and address of licensed contractor____..__ -------------- - --------- - - ---------- Location and legal description of lot to be built on: Lot.. Block ----- 11 1 1 - - -p -- - - - - -- -- - - -- -- Subdivision - -- - -- - -- Street and Number where work is to be State work to be qone and purpose of building (by floors)_________- _____._____:_- - I --------- -- RdAillz./u --------- 7,jc --------------------- ---- ---- --- ------- --- --------- _Al =------- - - - - -- ------------------------------ ----- - - - ------------- ---------- 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 $ ------- ----- ----- Zone cubage required - - - -- -------------------- - ------------ - ----------------------------------- Plan Cubage ------- -------------------- - ---------------------- -- ------------ Distance to next nearest building___________ ______.___-__ __..______ ___ __________.___ - -_- __Size of Building Lot____________- ___________- ___- _____________ ---- ---- Maximum live load to be home by each floor --------------_---------- - ------------- - --------- ----------------------------------------------------------------- - I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to--------------------- ----- ----------- -- -- - - - - -- ---- --- -------- ---- --- -- -- -- - - - - -- --- - - --- ---------------------- _ ---------____--- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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------ --------------- - --- - -- -- - - --------------------------------- --- - -- (Signed) -------- ----------- --------- •- -- --------- --- - ----- ------- - ------- STATE OF FLORIDA, COUNTY OF DADE. j ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 ------ ? ?--- ------------ 177-1 ---- 11'-_70� Date ------ 1 ----- ----- - C -1 --- --- Read, Sworn to and Subscribed before me. -- ----- ------ Disapproved --- �q ------------ Date -- - ------- - ------- ---- ---------- - Not - ary - Public, State - - - of Florida ------------------------------------------- i�, ---- i4 (Signed ------- - -- ---- -- ------- --------- ----- - Building Inspector My Commission Expires ------ ---------------- -------------------------------------------- FLANN' ' OARD --------- -------- ---- ---- -- ------ - -- --DATE Chairman----------------------- ----------------- ------------ - -- --- - 7 ------ -------------------- Member --- -------------------- Member-- ---- -------- - - - --- ---------------------------------------- - ------------------------------ - - Member Member----------------------- - ----------- - ------- - ------------ - -- - ----------------- - - ------------- Member ----------------------------- ------------------------------ Council Approved------ ---- ----- ---- --------- ... - - - -_ ------- ------------------ __ ---- Date Disapproved -_ . -- --- ---------- --------------- - ------ ------- ------ ------- Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. 4-j� a h 46 '7 0- ""1( 1 & C k• -Pv . 71 MIAMI SHO E VILLAGE BUILDING INSPEC+ ION DEPARTMENT APPLICATION FOR BUILDING PERMIT / kk,1 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 a building during progress of the work. Owner's Name and Address __ < ............ .. �a. ...... Registered Architect and /or Engineer.__- _- .__.- ._- . -_ - - -_ Date. a� L , - (T - ---- - - - - -. = 1 �� {� Street - - - - - -= - - - - -- ------- - -..._ --- -- - - - - -- -- --- - -- _....••-------••-•-------••-°-••--•_..._. .......-••-...................................... Name and address of licensed contractor ------------------------------------------------------------------------------------------- .............................................................. Locatign, and legal description of lot to be built - --- --- -- - - -- Subdivision -- - -- ---- --- - - - --- - -- L� D� . Lot. -�-- -y�-- -•--- ------------ -- - -- - - - -- - Block - - -•>�� -� � --- •= -- •- - - -- - -------------•---••---- ••-•-- ---- -•- --- •----- •- - - --• -- Street and Number where work is to be done--- --- --- ----- -- - - - - -_ State work to be done and purpose of building (by floors) ...................................................... ............................... . •--------._..-----•---•-.-----°-•--•-•--••---.......•---•-•-----••-•-•--•--•----•-°• -- ---- •--- ••- ----- -- •-- •-•• -• -- •- •-- •-•------ - -- -•• ..__....._...•--•...••----•-••--••-----•-----------••------...• •- -•--- ••-•- •- ••-- •- •---- • -• ° -- ...-•------------•---••------ ...................................................................................... ----- ------- -•------ •-• -- -- --.-.---------- ,.-- ----- --- --- -•---- -- - -• --- and for no other purpose. New Buildin g-- --- ---- -- -- ---_ _______.. Remodeling __. ------------- •-• - - -- Addition .------ %�- - - -- - -- Repairs .......................... No. of Stories ...... ................... To be constructed of_ ...... ....... .......__ -- Kind of foundation ----- - ---------------------------------- --------- ..----------- Roof Covering ................................... Estimated Total cost of improvements $.....- _____ ______ _______._____.___..__.__.Amount of Permit $ -------- ............................................................... Zone cubage required -------------- ------------------------------------------ ...................... Plan Cubage ---------------------------------------- Distance to next nearest building .................... ............................... .........Size of Building Lot ------------------------ ._ ....... _................................................ Maximum live load to be borne by each floor-------•------------------------•----•------- -- ------ -- •--- -- ----- ---- --- -•- ----------••-•-•-- ...........- °•- --•-•--- -_..._ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to._ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations is an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup dement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employe by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfo ed u er this permit, as are licensed by Miami Shores Village. a�,` , -T -Kf v Remarks--•----------------------•--------•-°•-----------------•------ •---- ---------- ---- •--- -- - - - - -• (Signed)- -��� -- •-- -- -- - -:_ •-___- ______1 "Uj -•ii - - �•-= ---- - -- ---- -- -- --'S�' STATE OF FLORIDA, COUNTY OF DADE. I ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared------ - - - - -- - - - - -- ----- •-- - - - - -- -------------•--•---------------•--------------------------------- - ----- --- ---- ----- -------- ----- - - - --- ------------------- ---- --- -- --- --- --- -- -- -- -to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. _ ------------------------------------- ____ _--- _.___- _- - -___. _ _ _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No ................ .� z_- ,3 - _____.__ Date... .... ..- �'___`r Read, Sworn to and Subscribed before me. Disapproved-- - -_- Date- - -- ----- - ----= -- - - -• -- ----------------- - -- -- ---- - -- -- --- ------ --- - ----- ----.------•---•--•----------------•------ f Notary Public, State of Florida ( Signed) `- ------ • - - - -• . -- -- - -- Building Inspeoto My Commission Expires -------------------------_-----•------ ---- -....................... P NNING BOARD ------ - ••••• -- ------------------------------ DATE Chairman t __ ------------------ 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 -ins ec on is made necessary by improper notice for id�-)ectitn or faulty materials and /or workmanship. �r. e F 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, '�j► - .._..._- - -� ........ Owner's Name and Address - �.... - ---- No...- -- T_?---- -. Street IP t =. .�. l�V... '. Registered Architect and /or Engineer - -- ------------ 1- ----- ---- -- - - - --- - --- - -- - -jJ -------- - Name and address of licensed contractor------ -- - - -- - - - - -- Location and legal description of lot to be built on: Lot------ -- - - - - -- --------------------------- Block -------- ----- ------- -- ...------- Subdivision. - ---- ---------------------------------------------------------------------•-•---------------- Street and Number where work is to be done------------------------------------------------------------------------------------------- State work to be done and pur se of building (by floors) ............. ............................__.._..........._.._._.___.......___ ._.___..____...___.....__...... s�t`�ev.,, ---- - - - - -- - -- - ------------------------- - - - - -- 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 $___...._C___..__. --- Amount of Permit $___________________________________________________ _________ __ ____ _••-- •- __- • -_ - -_ Zone cubage required - - - -- -- -- ---- - - - - -- -------------------------------------------------- Plan Cubage - - - --- -- ----------- ------- -- --- - -- -- ---------•----•------------------• • - - - -. _....----..._.. -- Distance to next nearest building _----------------------------------------------------------- Size of Building Lot ----------------------------------- .------------- .-------------------------------- Maximum live load to be borne by each floor ------------------------------------------------------------------------- .._.--------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to ----------------------------------------------------------------------------------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations :is an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subc tractors, on worjc to be perfor ed under this permit, as are licensed by Miami Shores Village. e�tf, Remarks----------------------------------------- ------ -------- ---- --- -- -- - - - - -- ------------- _ ------ ( Signed) - - -- - - --• ..... STATE OF FLORIDA, t$� COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared------------•--•------------------------------------------------------------------ - - - - -- --------- - - - - -- ...... - -- ----- - - - - -- -------------------------- -- --- --- -------- -- - - - -to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_____________________________________________________________________ - --------- - of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.--- -- -_ - - - -- --- -------- ---- --- ---- -- -- -- Date- - - -- Disapproved ------------- ---------------- ----- - - - - -- Date ...... (Signed) Building Inspector Read, Sworn to and Subscribed before me. --- --- -- -- - - -- - - - - ---------------------------------------- Notary Public, State of Florida My Commission Expires --------------------- PLANNING BOARD -------------- ---------------------------------------- -DATE Chairman._........ .............. --------------------------------------------- -------- --- •-- -- -- - - - -- Member ---•---------------------------•-------- Member----...------------------------------------------------ - - - - -- Member .-- _----- - - - - -_ -----------••-----------------------••-------••--- Member. Member ------------ - - - --- -- ------------------------------------------------------------------------ Council Approved. ------------------------------------------------------------------------- Date Disapproved --- -- --•-- ----- ---- --•- --- -•- -- --- •-- ---- -------------- --- --- - -- - - -- ---- - -- -Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ,, f ova/ 4 v -- MIAMI SHORES VILLAGE BUlLD7y4 INSPECTION DEPARTIVIE0 APPLICATION FOR BUILDING PERMIT Application is hereby made fo- the approval of t1w, det. iled statemen, of the plans and speciff La ions herewith submitted foi the build- ing or ,h� ^",tu^e her ^ con o,m ty w,th the Building Ordinance of &0^ x Shores Villave, or da, and all pro isim"m the Luw`'z the xmmo, f l,rid. all o nances of ^u Shores Village and all rules and mg".u*o. of the auumug Div / of Sho, iOvgo } `l = `o'`nLod votb, n6etbm, herein onvci6od or not. A copy of ^n»m''d plans and onvv/fivuu 'u` ^mm be kx/ ' at buu6/uo dorio" nmg/vva of 6.evr6x. ;L ~°��~ �� Dx�.-__-_-������- �� -��_�-_-__.z8--- Owner' Name ="A"�=^ ��— -- xtrcet- _ --___ ____ Registered Architect uud/orEuginorl --_ _-- _- _-__-- _ _ --- ------- ---- --- -_ Name ud address of|/«oed contractor - � �~ --'-_-'----''�_--_--'._�- Location and legal description vf lot to6e built on: Lot _ ------------ ------------- ' Block _---- - ------- Subdivision ------------------------------------------------ -----__ Street and Number where work is to be done S,�v nmb to be done and purpose of building (6r8vmm)-_��~°�-�cm^�--'_1_\-��������zrr�' ,«_/ _-_--°���-~.-'~^---_~. --------------------------------- --------------- '-_-___----_----------------------------- --- ------------------ -------------------------------- ---_------------ --'-_-.--__--===~� __________________ ___ __ ----- ------ _______' ------ ---- ----------------------------------------- -------------- --- -.- and for no other »n/nom. New Building ---------- Remodeling -- -- _ ---- Addition ---- ---- --- ----- - Bonuurs- No. of Stories ' To be constructed of- �����6�/uu -' ---' - '� -- -- ug- -- . «�-��°�� �num^��J��udc*o�of/m»�vrvmoum *_ ����'n�~� __' -_- �moo/� vF ��oou *- �� ------- _-' I000 ~"hu«o required- _ -- ----- -' --- __- ----------- - _-_- Plan Cu6uge_- -------- -- -- ____._ --- .. .� Distance to next nearest building-- -------------------- ---Size of Building Lv-_-'_' Maximum live loud to be 600m by each floor, '--_ _ _ - ------ ------------ _.._________________.__ hereby submit all the plans andmpeciii,�ations for said building. All notices with reference to the building and its construction may be sent m------ - _ - '_-- The unde signed appli ant for th s bu,*Iding pe-mit does hereby certify t7lat be understands and m,mvnuuo � and b s corripl ed w;th he prov',ions thereof, and will require s,milar conn) iance from all contractors or sub �contractors m the vmxm000� mou mz�o�mu am ���mum m � public m ot�'susmm/enoodL' the Act. The o.J.riouJ agrees m employ ouh�such inspection noou� as �v licensed by ��am, Shores �U..ur. 4�lrs, Bmmu6m- --- - '_-- ---_ _ '_- _ -' (S/unad) ��/8zATE0F FLuozDA ' � ov COUNTY OFDADE. � ' ---�F Before me, the undersigned authority, u notary public, duly authorized marlm.nimerv�k ���� v�o rers^nally"p- _ _____ _ --- _--- _ _ ---_ -- __' -------------- ----- ____' *oom well known, and who, being by me first d ly qworn, upon oath --- --- _--- of th ^oo, uo,`mou - .vouumuu 'u has carelilly read the foregoing application, and that he did sign the same, and tl`at all facts therein by him stated are tr ie. rouu4t Nv------- Date -- -- '�---- aouJ Sworn m and Subscribed before mv omu»nrvvod ______'- ____'' _-----'-_'_-_-._-_-_---_---__________- ��ry������o�u (Signed) --'-'_-_ - ` ------- ------- ----- ----- PLANNING ''- - -- --DATE Chairman __ _ -------- --- __ - --- ---- ----- ----- Member _' -. ----' _- -__-' -- __ - _ __ -- Member _' - -_ _- __'- _-- __ ____'___' Member .'_ - -_ '_ --- -__.._____- _ _. Member - _ ----- __ ' ___-____'_- ------- Member - - '---____-__ _____.__ _____ _ Council Approved _ -_ _ I)�e Ixmpn'o,mf - _. _ Date NOTE: A charge of $1.00 will be made for making ,orre,hvoo or 26xogo m this application +,,r approval lr/`�,eu�tx`uo] from H`ry6o,ugB"md ~ A re-inspection re—inspection 6e, of *l.0O will 6v charged when ouchrv`/oo»o,,iou is m*'_io o,^vso^r' 6r improper notice for iu,ne.+or or 6'/ty materials and/or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No ...................... Date................. -" . .. ......... ............................. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address........ .- . -1{•- :••.•1. . .......... ............................... Street..................... ............................... RegisteredArchitect and /or En y' ......... ........................:...... ..............................---...................---..................... ............................... Employing Electrician's Name...... .�./4. ....... . J..... No ............ ............................... Street---.................- --- --.......................... Location and Legal Description Lot ............ ............................... Street and Number where work is to be performed— No ................. State work to be performed and purpose of building (By Floors) ............ Block ........... ............................... Subdivision.......... ............................... ...� –� ..7 ...:........................... Street.... :.. ........ .. :. ..... .... New Building .......... .... ..... .. ........... Remodeling ............ ....... .......... .. Addition ..... .. ... .--- ............... Repairs ...................................... No. of Stories ................. --- Service Overhead Size Feeders. ................... Conduit ............. ...Main Sw.. ... .......................... Am s.................:. Underground Amps Main Fuses Amps Type of Installation — Conduit ........................ Tubing................-....... B. X. L.........................Metal Moulding. ............................... . ......... ............................... ....................................................................................................................................................................................................................... ............................... .................................. ............................... .................... ................- -- ............ .. ... . .............. ............. Amountof Permit $ ................ ..... ........................................ I........... ( g )................... .. .. .. ............................................................... 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 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 sub, contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed ........ ...... ........ ......... .................... STATE OF FLORIDA, l ,» Master Electrician. COUNTY OF DADE. JI 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 /aterials OTE: A re- inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty and /or workmanship. I SWITCH LIGHT PLUS FIXTURES REFRIG. IRON RANGE RANGE WATER I W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T'S NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CONTR. - LIST - CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1.3 HP TRANS. CONTR. LIST CHECK Service Overhead Size Feeders. ................... Conduit ............. ...Main Sw.. ... .......................... Am s.................:. Underground Amps Main Fuses Amps Type of Installation — Conduit ........................ Tubing................-....... B. X. L.........................Metal Moulding. ............................... . ......... ............................... ....................................................................................................................................................................................................................... ............................... .................................. ............................... .................... ................- -- ............ .. ... . .............. ............. Amountof Permit $ ................ ..... ........................................ I........... ( g )................... .. .. .. ............................................................... 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 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 sub, contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed ........ ...... ........ ......... .................... STATE OF FLORIDA, l ,» Master Electrician. COUNTY OF DADE. JI 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 /aterials OTE: A re- inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty and /or workmanship. I 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. C Date - - -- --- ----- -- - ----- - -- -------------------_------- - - --- -- 'S / J Owner's Name and Address_._____ --' ..... ------- T19)!1jC J4 __ _ - Street__,_ ---- -- A0O -A.._O 37— Registered Architect and /or Engineer - - - - -- - ---- --- -- - - - - -- - - - ----------------- - - -- -- Name and address of licensed contractor - - - -- - 2 "'"J - - Location and legal description of lot to be built on: Lot-------------------- -- ------ ---------- - - ---- Block --------- ----- - - - - -- Street and Number where State work to be done and �-�. - ------ Subdivision._._. _ __ ___ ____ ___ __________ __and for no other purpose. New Building --- ---- ------- -- ----- ---- - - - -- Remodeling ----------------- Addition ---- -- --- -_- --- --- ._-_- -- Repairs -------------------------- No. of Stories. ----- ----- To be constructed of ----- ------------- -------- . Kind of foundation --------------------------------------------------------- ------ Rolf Covering --------------------- ------- Estimated Total cost of improvements _____ ______ ______Amount of Permit $..__ _ ________________._________. Zonecubage required--------------------------------•------------- ------ ------------------- ---- -- -Plan Cubage ----------------------------------------------------------------- Distance to next nearest building . --- --------- ------- - -- - -- ---- - - - - -- _---- --- -- --- - -- -- -Size of Building Lot. --- -- _- --- ---- •-- -- - - -- ---- --- -- - - ---- ---- -- - ---- ............................ Maximum live load to be borne by each floor ---------------------------------------- --------------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to ------------------------------------------------------------------------ -------------------------------------------------••------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performer under this permit, as are licensed by Miami. Shores Village. Remarks------------------------------------------------------------------ ----- --- ---- ---- -------- - - - - -- ( Signed --- --- --- - - -- -- -------- - - - - --- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ------------------------------------------------------------------------------------------------------------)--------------------------- -------------------------------------------------------- --------------------------------- ----------- ------------- - - - - -- -------------------------------------------------- --- --- -- --- ---- --------- - - - - --- ------------------ --------- ---- ------------ - - - -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 dad sign the same, and that all facts therein by him stated are true. Permit No ----------- 1. 71 3•___ _____ ________ Date_____________ _L_ _!, Read, Sworn to and Subscribed before me. Disapproved----- -•--•- ---- -- ---- ---•---- --- D t ------------------- --- --------------------- ----- ---- - - - - -- ------------ -- ------ --- ---- --- -- - - -- -- ---------------------•-------------------------- Notary Public, State of Florida (Signed) --- -- ---- ----------- ----- --- ... - -- - -- --- Build Inspector My Commission Expires -------------------------------------------------------------------- BOARD---- -------- -- - - - - -- ----- ---- - - - -- ---------- - - -- -- -.DATE Chairman------------------_----------- •-------•---------------------------- --- ---------------- - --- -- Member --•-------- -- ----•------ ---- ---- - - - - -- - - Member---- --------------------------------------------------------------------------------- - -- -- -- - --- Member Member- -- -- ---- ---------------------------------------------------------- ---- -------------- ---- --- --- Member -------- ---------- -- --------- ---- - - - - -- - Council Approved.---------------------------------- --------------- ---------- - - - --- - - - -- -Date Disapproved . -------------------------------------------------- ........ _... Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE 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- in 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. Owner's Name and Address ... ...- -------- .. ... . ..... ................. No2-6 /A ...... •.. Registered Architect and /or Engineer...-.- -- - ---•- ............................... -- •- --- --- .......... . ................ Name and address of licensed contractor ............... 0. '„i*z.- ''_'�..._..� .. -- •. -- ._._.. ......................................... Location and legal description of lot to be built on: Lot ------------------- ------------- ---------- Block ------------ .------------- - - -- - -- Subdivision. Street and Number where work is to be done .. .. .. ...... ...... ...... .. ............ State work to be done and purpose of building (by floors r ..! --------------------•--------------------•------•-••-•-----------.-- _- •.---- ------ -••- ----- - - - - --r ------------•---------•-------------•----•-•---- ---- ••-•- ------ ----- ---- - - - --- - - - - -- and for no other purpose. New Building- .-- .__.____-- ............. Remodeling --------- ............... Addition .......................... Repairs......... ----- No. of Stories. - -._ ................... To be constructed of__.._--- •- -••----- --- -- ---_ Kind of foundati :1p.-- --- _-- ---- ------ ------ ............... Roof Covering ................................................ Estimated Total cost of improvements mount of Permit $._---_° � ------ f-________ ._._.__.....___._____..___...._ -•----------------- -•- --- Zone cubage required --- -- -- -•----- ••- -- ------ --- -- - -- - -- ---Plan Cubage- ------ --------------------------••••----- Distance to next nearest building ----------------------------------------------------------- Size of Building Lot ------------------------- ......................................................... Maximum live load to be borne by each floor ..... _-------------------------------------------- ._________- _- __..•__. I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to-- --- ---- - - ---- --------------------------------------------------------------••------------------ ------ •-------- ------- -- - - - - -- -- -- - -- - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup m deent, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employe by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this- permit, as are licensed by Miami Shores Village. Remarks------ -_-- --- ---- --- --- •-- _ -- -• -- -------------------------- ---- --•-- ---- -- --- ----- -- - - -- -- ( Signed) - - -- -- - -- - -- • -� STATE OF FLORIDA, 1 COUNTY OF DADE. j 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 lie has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him sttatted are tru j Permit No.___-- _`__.__..�.�--- ____ -___ Date.___ j.. — _....- _Read, Sworn to and Subscribed before me. Disapproved Date__ - -- - - - -- - - -- -- --- ---------- - -- --- (Signed) - -- '� } o. ,.. Notary Public, State of Florida Building Inspector My Commission Expires -------------------------------------------------------------------- PLANNINGBOARD --------------------------------------------------------- DATE Chairman__...---..........--------------------•- ---•---- ------- ----- ----- ------ -- -- ---- -- -- _-- --- Member ------ = ----------------------------------------------- ........ Member------------- ---------------------------------------------------------------- -- ---- -•-- -- - - -- Member ---------...---------•------------ ------ ---------- - - --•- Member.. .................................................. - - - - -- ................... --- •-- ---- •• --- -- Member - -_---- --------- - - - - -- -- •--•...... - -- CouncilApproved-- ------------------------------------------------------------------------ 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. AIW "y f� •1 N M U t . ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.... ...`�. ... ~ ............... Date............... �a�.....9 , 195 7............... -- 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. WILLIAM KOFOED No ........257 .................... N.E. 103 Street Owner's Name and Address.,... ...........................•----•--°---.. ..........................._... ..... Street------.......--••--.. ........................._..... RegisteredArchitect and /or Engineer ................................... ..................... .................................................................................... ......................................... Employing Electrician's Name ..... BUR:N.`...........J AEG ��.. .................No..3. .. ............................ Street.e... ..�I... St e -et �.9— E 2 20 119 A. re s Location and Legal Description Lot... -e.Cti.on .... 5 ----------- Street and Number where work is to be performed—No ...... 2 5-T ........................ ............................... Street.... N.. E,...... 10.3.._.StY:eet_............... Bathroom Addition State work to be performed and purpose of building (By Floors) .... ......... . .... I...................................................................................................................... New Building ............... ....... Remodeling Addition xX-- -- --............-_. Repairs ................................... ..No. of Stories .................... Service Overhead Size Feeders ............ ........Conduit................ Main Sw._.-- --.. ...................... Amps ........... .. ........ ...... Main Fuses ............................ Amps Underground Type of Installation— Conduit .................. ...... Tubing ........................ B. X. L ......................... Metal Moulding ........................................................................ ..................... ............................... .............._.......................-•----....................._.... ............................... ....-•°.........-...- •-............................ ..F.. .�• '1.. 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act.. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. G (Signed) .......... � .....C.`.h ... ..... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. !r ss. Before me, t13e 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 be is the .......................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................................... ............................... ............................. _.............. •-•---.......-•------•---.......... ............................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. SPACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T's NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CONTR. — 2 3 LIST 1 2 CHECK _ _ - ENT, D ST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1.3 HP TRANS. CONTR. _ LIST CHECK Service Overhead Size Feeders ............ ........Conduit................ Main Sw._.-- --.. ...................... Amps ........... .. ........ ...... Main Fuses ............................ Amps Underground Type of Installation— Conduit .................. ...... Tubing ........................ B. X. L ......................... Metal Moulding ........................................................................ ..................... ............................... .............._.......................-•----....................._.... ............................... ....-•°.........-...- •-............................ ..F.. .�• '1.. 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act.. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. G (Signed) .......... � .....C.`.h ... ..... Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. !r ss. Before me, t13e 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 be 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. VL. 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. G Date--- ---- _ -• - - -- --May -- i---- -------- - - -• -- 5 7 ,19 "nm . Ko.. Old------ •_........................ -------------------------- No ....... 257 Street N 8. 103rd St Owner's Name and Address .....__.:_.._.._.____.__..__. Registered Architect and /or Engineer. - -- ........... ---------------------------------- --------......------------------- ---- ------- --- --- -------- - - - - -- ------ .------------------------------------------ Name and address of licensed contractor ----------- Sheet Metal Se c ia l t C Company, 573 N. W. 71st St. -- - -------------------------- -------------- Location and legal description of lot to be built on: Lot--- 19 - -`A` E•' - 2....2`0 -.. Block. 119 Subdivision Miami Shores, - Section 5 -- -- -- -- - - - - - - -- Street and Number where work is to be done_____.. -_.- _257.___7` --___E- .___1Q3rd- __Street Street State work to be done and purpose of building (by floors) ----------- RO Of _ng ----------------------------------------------------- d dn. to residence and for no other purpose. New Building--- ---------- ------- -- - ---- -- Remode ling ----- ---- ---- ----- •-- - - -- Addition- - -- -- ---- ----- - - - --- Repairs-------- -- --------- - - - - -- No. of Stories--•---... --•- ------- - - ---- To be constructed of -------- Kind of foundation------ ------ ---- ---- - - --- _--- .__- __-- .._- .- . - -.___ Roof Covering__ .... barrel t ile Estimated Total cost of improvements $ ------ 94_9.0.0 . ..___I ..................... Amount of Permit $.- ._-- ._....__5! 00 Zone cubage required ------- --- ---------------------------------------------------------------------- Plan Cubage------- - - - --- ----------------- Distance to next nearest building. ----------------------------------------------------------- Size of Building Lot ----------------------------------------------- ... ............................... Maximum live load to be borne by each floor---- --- -- ----- -- -- - - - - -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent 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 Suglement, 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 ------------------------------------------------------------------------------------------------ (Signed) -------- S----HE---=-iT")T ------------------------------------------------------ ETAL SPECIALTY CO. 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. _ Permit No ------- •__x_7.1 ------------ _ ------------ Date___,` _ ---------- ty� Read, Sworn to and Subscribed before me. Disapproved --- --------- - ---•-- ----- Date - - - - -- _ ----- — - -- ------- ---- -- --- --- -- ---- - - -- -- - -- - --- - -- - -- -- - -- -- - --- -- - - - - Notary Public, State of Florida (signed) --- --- --=---- --- - j- -,• -- --- - ` -- __ _ _ - -_.-------------- ---= =-- -�- �-- -- •- --- - - - - -- Building Inspector My Commission Expires ------------- .......................• ........._....-- .•.------ - - - - -- PLANNING BOARD -------------------------------------------------------- DATE Chairman--- ------- ............ -••- --- - - - --- - -- --------- --- -- --- -- -- -- --- - - -- -- ------ -------- - - - - -- Member --- Member---------_-------------------- ---- -- --•------- ------ ------------------------------------------- Member °- Member._.._._ --••----------------------•-------------•-•------------- •------ --- ---- ------ • - -- - Member ------_-_-------- Council Approved ------------------------------------------------------------------ ....... Date Disapproved -•--- --- - -- -- -- -- -- ._. - -- ............Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. v MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 7 Date ----- - ` - -- - -- - ---- Permit No.------------__._-- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other Application herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, stiucture and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and arovedsplansrandl specifications muatnbe kept at of Miami Shores Village shall be complied with, whether herein specified or not. A copy pp buald ng during progress of work. e �,z.r % . ------------- — No. — - — - - - -- - - - -- - Street - - Owner's Name and Address--- - - - - - -- '---- -- ----- - ---- - --------- - -- - --- ...................... Registered Architect and /or Engineer- - -_- -- - E aS = ..,,_. , .� rter ►, �� __ No. -__ — -- - - - ______ Street_ - - - — — --^-a-R -- ---`.-1" ---•- ------------ ying Plumber's Name 1 o .a. —Z C �----- - --- - ------- • Subdivision '______-- �--- •�-- '...._ ____.. - - - - -- Location and Legal Description Lot -- 1=� -- of - Street_-- - - -j � -- �' - -------- -------- and Number where work is to be performed—No._—__—_-.__----- �_ -•-••---•--•-•- -- State work to be performeil and purpose of building (]BY Floo rs) - -- ---------- - - - - -` � --- - - - - -- --- ----- - - - - -- -- -•------- New Building - - - ---- Remodeling ----- ------------------------- Addition --- - ----- -------- - - - - -- Re p aus ----- ---- - - - - -- No. of Stones. - I TOTAL CATCH FLOOR DRINKING SLOP LAUNDRY FIXTURES LAVA- URINALS BASIN DRAIN FOUNT'NS BATH SHOWERS SINKS SINKS TUBS CLOECTS� TUBS TORIES Cc R. / LIST `�- r CHECK SOLAR DEEP SPRKLR. $EPTiC SEWER DRAIN SOAKAGE CTRASE HEATER WELL SYSTEM SPOOLG _ - - - --- TANK CONN. _ FIELD Cc R. .� I LtsT CHECK ---- - ----- - - -- --- - ---Capacity Gals ------- ---------- ---- ------ - - ---. .- .- ..- -- - - -- -- -- -- -- -- -- ---------- Type of Tank----------- --- -------- ---------------------------------------- --- - - - - -- - - Size Septic. Tank---------- ------ -- - -- - -- -- ---- -- • - -• - -- _ -- -Dist. Feet of Tank or Drain Field from Well--- -- --- --- - - - - -- ----- - - - - -- --------- -- •--- -•- ----- --------- •---- -. Feet of Drain Tile __.- _--- - - - - -- ----- - - - - -- -- -- Nature of Water Supply: City— Well.-- ------ ----- -- ---- --- - - - - -- ----------------- -Size of Soakage Pit ---------------------------- ------- ------------------------------------- ------------------ ---- ----------------- ----- ------- --------------------------------------- ---------- ------- --------- --- --- --- - - -- -- -- - -- " "" "` ' Plumbing Inspector. Amount of Permit 5--------b------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an slndellof labor under the Florida Worean ereof and will requir Section frompalldcontrac ors Laws of Florida employed by him in the work to be plied with the provisions post or cause to be posted for inspection on the site of the work such public notice or n ices as are performed under this permit; and will P required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be peifor,�tied under this unit as are licensed by Miami Shores Village. �y -------- -;� R -- - - - - -- - (Sip "" L - Master Plumber. f STATE OF FLORIDA, a m COUNTY OF DADE. j rized to administer oaths and take acknowledgments, personally appeared Before me, the undersigned authority, a notary public, duly autho -- -- - -- --------------------------- to me well known, and who, being by me first duly sworn, upon oath depos� and says a is that he did sign the same, and that all facts of the above r described tecoonne�uction, that he has carefully read the ffore omg application, theaein by -- ------------ - - ---- My Commission Expires__--- - Notary Public, State of Flori a NOTE: A re- inspection fee of $I.()D will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty NO materials and /or workmanship. 0 MIAMI SI' ORFS Vli, PLUMBING INSPECTION DEPARTMEIN•' APPLICATION FOR PLUMBING Fermat No ------------ ------------ ------- Date_-- Application is hereby made for the approval of the detailed statement of t;,e plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and confok uxity with the. building Ordinance of Miami Shores Village; Florida, and a1T provisions of the Laws of the State of Florida, all ordinances of Miamr' :Shores Village and all rules and regulations of the Building Division of Miami Shores Village sl;rli be comphad with, whether hessin specif c-d ov *ne? , A cor,., -A approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ------- ___d `� - '-- -- ------- �f -u_-- - ._--- �`� - - -- -- __....___. - --- No._._____� °�-- 7- ---- - -- -._ Street__. --_ -- ------- --- - - -- Registered Architect and /or Engineer - - -_ - ----7--- ' - - ... - - - - -- - -- -- - -- / Employing Plumbers Nam X021 lt'tc A_X=I-1- No.______. (%- _- .___.__ Street ............... .......... Location and Legal Description Lot--- _-------------- _--- -- -- _- -_ -_ -, T _- Block__ Subdivision.--_-- - --- - -- Street and Number where work is to be performed-No -------- _ _ ___�__ (... . street ----- N.._ l ,0`3 __ . - -- r -- - State work to be performed and purpose of building (By Floors) ..... .---- ��! !_r- __.____._- _ /�f /�L -l� -- -5 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 ---------------------- -------- ---- -------- ----- - ------- Size of Soakage Pit------- - - - - -- _7 Amountof Permit $ --------- - ------ ------ -------- - - - -- — - - -- ( Signed)-------------------------•---------- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the k such public notice or notices as are equired by the Act. The undersigned agrees to employ only such sub -con etor , on work performed under this permit, as are licensed by Miami Shores Village. /�_ 4 ( Signed ) STATE OF FLORIDA, COUNTY OF DADE. before me, the undersigned authority, a notary public, duly authorized to - ------- - - - - -- - -•- -•---- Master Plumber. oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and saya 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 bim stated are true. Illy r"•r_immission Expires —_ __ -- -- -of ----- Florid - --------------• --- - - - - -- Notary Public, State a INOTE: 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 SHOWERS LAVA- SINKS SLOP LAUNDRY URINALS CATCH FLOOR DRINKING TOTAL CLOSETS TUBS TORIES SINKS TUBS BASIN DRAIN FOUNT'NS I FIXTURES -EON YR. I -. -- .-_LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CON". _ -_ - -_- LIST 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 ---------------------- -------- ---- -------- ----- - ------- Size of Soakage Pit------- - - - - -- _7 Amountof Permit $ --------- - ------ ------ -------- - - - -- — - - -- ( Signed)-------------------------•---------- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the k such public notice or notices as are equired by the Act. The undersigned agrees to employ only such sub -con etor , on work performed under this permit, as are licensed by Miami Shores Village. /�_ 4 ( Signed ) STATE OF FLORIDA, COUNTY OF DADE. before me, the undersigned authority, a notary public, duly authorized to - ------- - - - - -- - -•- -•---- Master Plumber. oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and saya 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 bim stated are true. Illy r"•r_immission Expires —_ __ -- -- -of ----- Florid - --------------• --- - - - - -- Notary Public, State a INOTE: 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 2 .3, MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No ......1:..: .............. Date....In� \1` ................ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address.. `\ ......... ........................................... No..... \......................... Street. \`� ..: RegisteredArchitect and /or Engineer... ....... .......................................................................................................................................................................... Employing Electrician's Name �t',2� ? ..� C' .................. ,... �........ Street. \:il.'5ir: .......` <. ....... Location and Legal Description Lot ..................................•- -.......... ^^................... Block........... ............................... Subdivision................. ............................... Street and Number where work is to be performed— No.... . ................................ ..................Street.....1 ....................... State work to be performed and purpose of building (By Floors ) .............................. New Building ................................ Remodeling ............................ ... Addition ........ .......... ............ Repairs ...................................... No. of Stories .................... Service Overhead Size Feeders .................... Conduit ............. ...Main Sw ................ ............... Amps ........................... Main Fuses ............................ Amps Underground Type of Installation— Conduit ............. ........... Tubing ................. .... ...B.X.L...._.. .................. Metal Moulding......................................... ............................... ........................................................................................................................................................................................................................ ............................... �c Amount of Permit 5n ...................................... ............................... (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 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 sub• contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. r i ( Signed ) ............................. :t .1../.1.:...1.................. ............................... / � Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 168' 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 te•ins ection 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 OUTLETS RECE•P•T•s NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. 0.1 HP 1•S HP TRANS. CL STR ``PP�E�RMM.^. CHECK Service Overhead Size Feeders .................... Conduit ............. ...Main Sw ................ ............... Amps ........................... Main Fuses ............................ Amps Underground Type of Installation— Conduit ............. ........... Tubing ................. .... ...B.X.L...._.. .................. Metal Moulding......................................... ............................... ........................................................................................................................................................................................................................ ............................... �c Amount of Permit 5n ...................................... ............................... (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 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 sub• contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. r i ( Signed ) ............................. :t .1../.1.:...1.................. ............................... / � Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 168' 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 te•ins ection 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. t1 r/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT J �S APPLICATION FOR ELECTRICAL PERMIT Permit No ...... »1...�J /.1/ ................ Date...:` 1 �' I Application is hereby made for the approval of the detailed statement of the plans and specifications erewW th 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.... .... il.:....................... ................:.- ............ ...I .... Iv. v...:............. Street..................... ............................... RegisteredArchitect and /or Engineer ...................................................................................................................................................... .....••........................ Employing Electrician's Name....: 12,) z` r.\ ...... ....... ............................... ....................... No ............................................ Street ........................................ ' 1h e� 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.................... Service Overhead Site Feeders .................... Conduit ................ Main Sw ............. Amps ........................... Main Fuses ............................ Amps Underground Type of Installation — Conduit ........................ Tubing........................ B.X.L.... ..................... Metal Moulding....... ............................... ... ............................... ...................................................'......................................................-----... ............................... .......... ................ ............................... Amount of Permit 5. .� :........................................ ............................... (Signed)_.0 .�.�2 11C-1' 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 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) ...................................................:................ ............I.................. Master Electrician. STATE OF FLORIDA, 1 COUNTY- OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared........................................................... ............................... .........................•.................................................................................... ............................... to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ........................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................................... ............................... ............................................................................... ............................... My Commission 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 OUTLETS RECE,P'T,s NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER CONTR. LIST CHECK ENT. D18T. SERVICE SERVICE f MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0.1 HP 1•5 HP TRANS. CONTR. LIST CHECK Service Overhead Site Feeders .................... Conduit ................ Main Sw ............. Amps ........................... Main Fuses ............................ Amps Underground Type of Installation — Conduit ........................ Tubing........................ B.X.L.... ..................... Metal Moulding....... ............................... ... ............................... ...................................................'......................................................-----... ............................... .......... ................ ............................... Amount of Permit 5. .� :........................................ ............................... (Signed)_.0 .�.�2 11C-1' 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 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) ...................................................:................ ............I.................. Master Electrician. STATE OF FLORIDA, 1 COUNTY- OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared........................................................... ............................... .........................•.................................................................................... ............................... to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ........................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................................... ............................... ............................................................................... ............................... My Commission 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 --R. Q� VW Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -414 Dr! nted:3 /14!2003 Page 1 of 1 Applicant: PETRONELLA KROBOTH Owner: KROBOTH PETRONELLA JOB ADDRESS: 257 NE 103 ST Contractor Contractor's Address: Local Phone: Parcel # 1121360130420 Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOT 18 & W1 /2 LOT 19 BLK 119 LOT SIZE Fees: Description Amount FEE2003 -1547 CCF $0.60 FEE2003 -1548 Building Permit Application Fee $60.00 To #al. Fees: $ $.60 0 Total Fees: $60.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/10/2003 Construction Value: $500.00 Work: EXTERIOR PAINTING AS PER AGREEMENT 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. equipment or device described in the application herefor In strict compliance with all ROBERT KROBOTH th any plans, drawings, statements or specifications that may have been submitted to PETRONELLA J. KROBOTH 2721 iot done in compliance with such ordinances or If the plans are changed without 257 N. E 103 ST. �y )r or builder named above assumes the responsibility for a thorough knowledge of the MIAMI SHORES, FL 33138 Date 63-27/631 R s or in the statements or specifications and that he assumes responsibility for work done 888 the N- "` 1 ACH R/r oemoom Fo F 1:063&002771: 00350469.2839118 2721 V, (V O BY: Dollars 8 ""' compliance with all ordinances and regulations pertaining thereto and In strict conformity 6 Village. In accepting this permit 1 assume responisibiiity for all work done by either BY: MIAMI SHORES-iVILLAGE 11: : 11 Paint Color Approtial &�id�Agreeinent DATE: f' OWNER'S r ADDRESS:.. ADDRESS ( a-2,- ... . ... CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: All Elements on the site must be listed and indicate the color to be painted. Walls ,Dabtf ? .Laid Fascia Q.A/F-rorpo,P n Drip Cap/Drip Edge CPf Al f- W603) o Soffit W Roof C' Flower Bins f-5 6Zq' eLat Mf Shutters 94ccy 2I.li6 Awnings? Cn Chimney. /j/ ,-J- Doors and door jams 12ks Ll Garage Doors Z Railings A1114 � Fences P /A- Cn Decorative Metal o cr-q 4U 001-k All brick (simulated or regular) P,1- Stucco Banding A f Any other stucco features 6 t Accessory Buildings All ' Other ` r 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. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached 4 igs nature o Owner Date Signature of Contractor Date APPROVED: Building Offidir Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 • u Sk" Roofing Components v4Wch make up Roof System Avembly at Perimaer Edge with Gravel Stop or Drip Edge. laud It, Componentstiamm Include flastener " and spacing used for woo& blocking auwhn=L Gravel St 'p Edge Gager Fastener rr g: Spacin O.Q. Clip Type: Clip Gage•. Deck Type. SOL v V60b Sketch Rooting Components which make up Roof. System Assembly at Perimeter Edge with Gutters. Iouert leaders indicating Roofing Component aamea, dWmWon%thicknesses, etc. Include fastener"and spacing used for wood. blocking attacbment. I Gutter Type: Gutter Gage: Fastener Spacing: Deck Type: PERII &—M DETAEL #4: Gutter Detail Built -Up Applications and Modified Bitumen Systems Page -6• aft aST U E 1O3 S"r l`a P IERCE Job Address: Contracto Process No. PERIMETER DETAIL #1: Parapet Wall Detail 8 Can Fastener _,_._ oc. Cup Type: Clip Gage: Dock Type: Tie-In To Existing Roof 91 , - Sketch Rooting Components which make up Roof I eada:s n otion Roong � Hama6 dime:dom6 thicknesses, eta. Include fad type and spacing used for wood - blwking attachmeaL Sketch Roofing Components which make up Roof Systevq,A embly at Perimeter Areas to be Flashed. Insert leaders indicating Roofing Component names . dimensioo:lhicknessgR, etc, d spacing used for woo& r <, 3 . (f L-- "Sze, e-S rl metal flashing a Ste steners S Strip 0 \ \; \! \ \ \ \ \\ PERIA+i,ETER DETAIL #2: Flashing Detail Built -Up Applications and Modified Bitumen Systems Page -5 e • • aS7 lU EE 10 3 sT a Job Address: ContractorIVI PERM. rocess No. Insect Building and Parapet Heights. (IjnoParapet eA*U, Insert W%A ") Also inset applicable infannadon pertaining to the building below. (SeeASCE 7•88Yact Sheet Attached) Exposure Category. Classification Category. Al Hurricane Oceanline ?: _ Y _ N Basic Wind Speed at Building I.00 don: 110 mph Building Condition based on of Openings: DC BUILDING INFORMATION #1 Built -Up Applications and Modified Bitumen Systems Page -8 X41 aS7,kJE10 3 ST M PIERCE Job Address: Contractor Process No. PEMM ETER DETAIL #5: 'Other' Detail a Sketch Roofing Components which make up Roof : System Assembly at any'othe' Perimeter Condition which may eidsit. Inset leades cating Roofing Component namek dimensions, thickessm etc. Include fastener type and spacing used for wood- btockingattachment J 0 //fJ YAl e I y J s 11 A i I. �5orN w s Sketch Roofing Components which make up Roof System Assembly at any'othe' Perimeter Condition which may Wit Insert leaders indicating Roofing Component mamas, dimesion% thickesse% eta Include fastener type and spacing used for wood- blocking attachment PERINOTER DETAIL #6: 'Other' Detail Built -Up Applications and Modified Bitumen Systems Page -7 • J Product Control No.: 95- 0330.06 4 �Hembrane Type: Deck Type 1: ' WAod,Nou- insular Deck Description: D2tEI.D1vw00d ar wnnri plank A�Ps System Type E: ase sheet mechantcalS�i e APP All General and System Limitations apply. Base Sheet: One ply of GAFGLAS® Ply 4, GAFGLAS® Ply 6®,' GAFGLAS® #75 or GAFGLAS® Stratavent® (N described below: eat Ply) for Nailable Decks mechanically fastened as Fastening: Lap base sheet 4" and attach to the wood deck with approved nails and tin caps 9" o.c. at the sidelap and two staggered rows 12" o.c. centered on the sheet. Note: Ply 4 and Ply 64D applications require sheathing paper over wood decks before application of anchor sheet. Ply Sheet: (Optional) One, two or three plies of GAFGLAS® Ply 4 or GAFGLAS® Ply 60D in type III or IV asphalt at an application rate of 25 IbJsq. f 15 %. Membrane: One ply of Ruberoift Torch Smooth, Ruberoid® Torch Granule, Ruberoid® Torch Plus Granule or Ruberoid® Torch FR torch applied according to manufacturer's application instructions. Surfacing: (Optional) Install one of the following: ' I. GAFGLAS® Mineral Surface Cap Sheet in type III or IV asphalt at an application rate of 25 IbJsq. f 15 %. 2. Karnak 97 or GAF Fibered Aluminum at 1.5 galJsq. or GAF WeatherCoat Emulsion at 3 galJsq (for Torch Smooth applications only).. Maximum Design Pressure: -60 psi; see System Limitation #3. , Maximum Fire Classification: 'A; see General Limitation #2. Maximum Slope: 3:12; see General Limitation #3. Specification No.: N- 1 -1 -TS, N- 1- 1 -TSC, N- 1 -I -TG r� ,1 Raul Rodriguez 40 ' /022 IN Product Control No.: 95- 0330.06 Raul Rodriguez 13 s Test Reports Test Ag n y Test identifier Test Name/Report Construction Research #4818 Wind Uplift 07/10/87 Laboratory, Inc. - Factory Mutual J.I.OT4AI.AM Wind Uplift 08/26/92 Research Corporation J.I. 1V7AO.AM Wind Uplift 07/16/92 J.I. 1V8A4.AM Wind Uplift 06/28193 J.I. 1R1A6.AM Wind Uplift 11 /15/91 J.I.OT2Q4.AM Wind Uplift 10/17/91 J.I.OQ6A6.AM Wind Uplift 07/16/91 J.I.2MOA4.AM Wind Uplift 03/21/87 J.I.3X3A2.AM Wind Uplift 08/02/94 J.I.OY9Q5.AM Wind Uplift 07/29/94 J.I.3X3A2.AM Wind Uplift 08/02/94 South Florida GAF -53 -X -915 Physical Properties 03/08/91 Test Service Underwriters R1306 Fire Classification 08/01/94 Laboratories, Inc. Dynatech Engineering, 3600.02.95 Wind Uplift, Small 02/02/95 Inc. Scale Raul Rodriguez 13 s U.J Raul Rodriguez 9 Product Control No.: 95- 0330.06 Product Dimensions Test Specification Product Description Manufacturer Red Rosi various Rosin paper for barrier generic layer on wood decks 00 w Minimum # PA 114 Corrosion resistant annular generic 12 • ring shank nails Min. 32 ga. x Corrosion resistant circular generic' I S /8" discs. ype X G um various Fire resistant rated gypsum generic rdi -T I various PA 110 Wood fiberboard Georgia - Pacific a ° t uminutn PA 121 Aluminum roof coating Grundy Industries r' f c ° ing G PA 121 Asphalt emulsion Grundy Industries In " al E " ion r #! Roofgrip PA 114 Insulation fastener steel, ITW Buildex wood or concrete decks dek Fastener PA 114 Insulation fastener ITW Buildex P ium Metal 3" square PA 114 3" square galvalume AZ55 ITW Buildex Pl ti stress plate S I' and Plastic 3" round PA, 114 Pol Y olefn plastic plate ITW Buildex Pla' ' Kar No. 169 r ASTM D 2824 Aluminum roof coating Karnak Corp. Kam ' 97 PA 121 Roof coating Karnak s Barrier and Plus various PA 110 Polyisocyanurate foam / NRG Barriers, Inc. wood fiber insulation U.J Raul Rodriguez 9 Product GAF Materials Corporation Jetblak Flashtite® Cement GAF Materials Corporation Plastic Cement GAF Materials �Corporation Miner 1l . Shield® Granules/ . Product Control No.: 95- 0330.06 Test Product Dimensions Specification Description 1, 5, 53 gallons �ASTM D 458— 6'Asphalt flashing cement. 1, 5, 53 gallons -ASTM D 4586 Trowel grade, asphalt plastic cement. 7 `GAFTEMPS / / various C otherm. R / t�FTEMPO ? posite various \ it GAFF EMP4 ermalite various GAFI�M4,;jFiberboard various GAFTEE 1' 0 various r i nerooara; GAFTITI� #12 Standard '1, Roofing Fas>ener GAFTI,T Q 914 Heavy Duty RoofiAg Fastener , NTB Fasteners GAFTITE® Base Sheei<, Fastener and Plate Gaiv' alume Plates 3" and 3 V? PoSYp ropylene Plates 3" and 3 %:" PA 110 High density wood fiberboard insulation. PA 114 Insulation fastener for steel and plywood decks. PA 114 Insulation fastener for steel, wood and concrete decks. PA 114 Fastener for use in gypsum, tectum and lightweight insulating concrete decks. PA 114 Base sheet fastening assembly. PA 114 Round galvalume stress plates. PA 114 Round polypropylene stress plates. U Raul Rodriguez 6 or 0 • Granules for surfacing of exposed asphalt, cold process or emulsion. PA 110 Polyisocyanumte foam insulation. PA 110 Polyisocyanurate foam insulation with high density fiberboard or Penualite perlite insulation. PA 110 Perlite insulation board. PA 110 Fiberboard insulation. PA 110 High density wood fiberboard insulation. PA 114 Insulation fastener for steel and plywood decks. PA 114 Insulation fastener for steel, wood and concrete decks. PA 114 Fastener for use in gypsum, tectum and lightweight insulating concrete decks. PA 114 Base sheet fastening assembly. PA 114 Round galvalume stress plates. PA 114 Round polypropylene stress plates. U Raul Rodriguez 6 or 0 • Product Control No.: 95- 0330.06 Prod Test Product Specif- Description 3' x 36" ASTM D 4897 Fiber glass base sheet impregnated and rataven (ent Ply) 69 lb. roll D 3672 coated on both sides with asphalt. for Nailable Decks. Surfaced on the bottom side with mineral granules embedded in asphaltic coating. GAFGLAS® 3' x 36" ASTM D 4897 Fiber glass base sheet impregnated and Stratavent® (Vent Ply) 69 lb. roll D 3672 coated on both sides with asphalt. Perforated Surfaced on the bottom side with mineral granules embedded in asphaltic coating. GAFGLAS Ply 64D 3' x 180' ASTM D 2178 Type VI asphalt impregnated glass felt 45 lb. roll with asphalt coating. 3' x 180' ASTM D 2178 T IV asphalt impregnated - . - YPe P glass felt 40 lb. roll with asphalt coating. A # 3' x 108' ASTM D 4601 Asphalt impregnated and coated glass 75 lb. roll mat base sheet. S® 3' x 36' ASTM D 3909 Asphalt coated, glass fiber mat cap sheet era Surfaced 76 lb. roll surfaced with mineral granules. Cap Sheet GAF Materials 5, 55 gallons ASTM D 41 Asphalt concrete primer used to Corporation Asphalt promote adhesion of asphalt in built -up Concrete Primer roofing. GAF Materials 1, 5 gallons ASTM D 2824 Fibere'd aluminum coating. Corporation Fibered Aluminum GAF Materials 5 gallons ASTM 1227 Surface coating for smooth surfaced Corporation roofs. WeatherCoat® ' Emulsion GAF Materials 1, 5 gallons ASTM D 3019 Refined asphalt blended with a mineral Corporation Jetblak All ASTM D 3409 stabilizer and fibers. Permits adhesion Weather Plastic Cement to wet and.dry surfaces. Raul Rodriguez 5 . ft Product Control No.: 95- 0330.06 Fibrous glass Perlite Fiberboard Polyisocyanurate Expanded polystyrene (BPS) Polyisocyanumte Composite Board Material Wood f Steel Concrete Lightweight Concrete Poured Gypsum Material {Wood `Steel Concrete Lightweight Concrete Poured Gypsum Design Pr c r psf -75 psf -248 psf -45 psf -45 psf Classification Class A C IL #T7,q � asCl s A�— Class A Class A Class A Note: Fire classifications and MgWmum design pressures do not reference all assemblies over deck types. Review system listings for design pressures and the Underwriters Laboratories Roofing Materials Directory or other approved testing agency listing directory for Fire Classifications. Raul Rodriguez 3 . a • • SYSTEMS PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL AR licant: GAF Materials Corporation Product Control No.: 95 -033n n_ .1161 Alps Road - - Wayne, NJ 07470 Approval Date: MAY 0 4 1995 Expiration Date: NOV 1 0 1 g g 7 Categon: Membrane Roofing System Sub- Cateeo Built -up Roofing T.Y Modified Bitumen Su- b'T.vle. SBS, APP GAF Materials Corporation has been manufacturing commercial roofing products for more than 100 years. GAF produces a wide range of roof products for built -up roofing systems. The modified bitumen products include both APP and SBS products in smooth, granule and fire rated versions. In addition, GAF offers two ply modified systems to meet the specification requirements for multilayer SBS modified specifications. GAF products are distributed through a wide network of roofing wholesale distributors throughout the South Florida area. GAF provides warranted systems over various insulated and non - insulated substrates, copies of which can be obtained from GAF and can be found in the Ruberoid Modified Bitumen Application and Specification manual published annually. GAF roof system assemblies have been extensively tested at Factory Mutual Research Corporation and Underwriters Laboratories. GAF modified 4itumen membranes have been tested in compliance with AST M D 5147 test-requirements. 0 M9TnoonaE METROPOLITAN DADE COUNTY, FLORIDA METRO•DADE FLAGLER BUILDING UUILDINa CODE COMPLIANCE t)EPAnTMEN7 SUITE I003 METRO•DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 03100.1583 PRODUCT CONTROL. NOTICE OF ACCF.PTANCF, FAX (aos) Ve -iooa GAF Materials Corporation 1361 Alps Road Wayne, NJ 07470 Your application for. Product Approval of GAF Materials Corporation Modii3ed Bitumen Roof Systems under Chapter 8 of the Metropolitan- Dade County Code governing the use of Alternate Materials and types of Construction, and completely described in the plans, specifications and calculations as submitted by Construction Research Laboratory, Inc., Factory Mutual Research Corporation, South Florida Test Service, Underwriters Laboratories, Inc. and Dynatech Engineering, Inc. has been recommended for acceptance by the Building Code Compliance Department to be used in Dade County, Florida under the specific and standard conditions set forth herein. The approval shall be valid for a period of three years. The Building Code Compliance Department reserves the right to secure a product or material at any time for a jobsite or manufacturer plant for quality control testing. If product or material fail to perform in the approved manner, the Code Compliance Department may revoke, modify or suspend the use of such product or material immediately. The Building Code Compliance Department reserves the right to require testing of this product or material should any amendments to the South Florida Building Code be enacted affecting this product or material. 0 The expense of such testing will be incurred by the Manufacturer PRODUCT NO.: ACCEPTANCE NO.: Otaul Rodriguez Product Control Division EXPIRES: NOV 1 n 1997 Supervisor - PLEASE NOTE - THIS IS THE COVERSHEET. SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS. BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade'County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade Co , lorida under the conditions set forth above. , APPROVED: MAY 1995 les Danger, P.E., Director Building Code Compliance Department Metropolitan Dade County aS7ME -103 sT Job Address: ContractoM PIE R C E process No. Reviewed Field Test Data ?: Y N Notes: Additional Notes: f Plan E=miner Built -Up Applications and Modified Bitumen Systems Page -11 b • • • aE kJE►03 Job Address: ContractoAA PI Etrocess No, -- FOR PLAN EXAMINER USE ONLY — goof System Assembly Product Control Ap rp oved: Y N If NO, note any deficiencies: Design Pressure Requirements: Field: Psf a Perimeter-- Areas: psf Comer Areas: psf Note any limitations: „; Reviewed Details ?: Y N Notes: Built -Up Applications and Modified Bitumen Systems Page -10 0 7 t�R Job Address: Contractor m Process No. Sketch Roof Plan Wcating A dbnezWON, MY alopaa roof drahn„ aWCCL% or roof top egoipraeat. Also inert variable labeled "a" which irutieates pernnda and comw d'bnersiom pa Chapter 23 Of tlm south Florida Code. (S"ASCE 7-n Fact Sheet Anwhed) .. BUIIDING INFORMA 1 lu'4 $L, KOOI rian wwt rGI11LLGW aaau a.vaan.s ,.auavaaaavaa a Built -Up Applications and Modified Bitumen Systems Page -9 Product Control No.: 95- 0330.06 12. Flashings shall be installed according to the manufacturers standard details, and may be applied in cold application adhesive, approved asphalt or may be applied in conjunction with an approved torch applied modified bitumen membrane. Specific details, approved by the manufacturer, shall be submitted with the Section II Permit Application. 13. Roll good materials shall be stored in strict compliance with GAF Materials Corporation requirements. 14. Consult current Underwriters Laboratories Directory for the appropriate coating for each roofing assembly to obtain the required fire rating. The assembly shall be installed in strict compliance with Chapter 3401.5 and 3401.6 of the South Florida Building Code for maximum fire classification. 15. Asphalt moppings shall be with applied with asphalt approved by the applicant and shall be approved in compliance with equiviscous temperature (EVT) methods of asphalt application. Asphalt containers or bulk tickets shall indicate an EVT, finished blowing temperature (FBT) and flash point. Asphalt types and temperature ranges shall be in compliance with Subsection 3403.4(a)(3) of the South Florida Building Code. 16. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt at an application rate of 25 lbs/sq. t 15 %, or mechanically attached using the fastening pattern of the top layer. Refer to manufacturer's literature and/or the NRCA Roofing and Waterproofing Manual for correct application procedures of insulation panels in approved asphalt or adhesive. 17. Pre - assembled cap nails may only be used for termination of fully bonded surfaces such as mechanical termination at wood blocking, head and side laps, and base flashing terminations. Cap nails shall not be used for the mechanical attachment of a base sheet. Tin caps are required by the South Florida Building Code. 18. The submission of system specifications and details shall accompany the Section II Building Code Permit. This information is available in the publications listed in the 'System Description' of this Product Control Approval. The submission of these documents, as well as the proper application and installation of all materials shall be the sole responsibility of the contractor. 19. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 20. Fastener spacing for base sheet attachment is based on a minimum withdrawal resistance value of 250 lbf as tested in compliance with Dade County Protocol PA 105. If the fastener values as tested are below 250 lbf a professional engineer may submit a revised fastener spacing utilizing the withdrawal resistance value taken from Dade County Protocol PA 105. Calculations shall be based on a rupture value (the fastener stress plate pulling over the base ply) of a mop th;9 90 tbf.. , Raul Rodriguez Ci 169 , Product Control No.: 95- 0330.06 General Limitations: 1. All asphalt shall comply with ASTM D 312 type III or type IV requirements. All proposed asphalt producers must be approved by the applicant. 2. Fire ratings are determined by a combination of slope, deck type and assembly. Refer to•current Underwriters Laboratories Roofing Materials Directory or other fire testing data listed by an approved listing laboratory agency. Fire ratings shall be in compliance with Sections 3401.5 and 3401.6 of the South Florida Building Code. 3 • Maximum slope range shall vary for each system; consult current Underwriters Laboratories Roofing Materials Directory and manufacturer's specifications for compliance with design criteria for each project. 4. An .overlay /recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no 'recovery board is used the base sheet may be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or.strip or spot mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 1bsJsq.. Note maximum design pressure restrictions on spot attached systems. 5. Any amendments to these provisions shall be in compliance with Sec 204 of the South Florida Building Code. p Sections 203 and 6. All work shall be performed by a Contractor licensed to do roofing work in Dade *County. Contractor shall be familiar with the details and specifications published by the manufacturer. 7. In re- roofing applications, moisture content in an existing built -up roof must be in compliance with Section 3401.9(c) of the South Florida Building Code. 8. Prior to application, all existing roof surfaces used as a bonding substrate shall be tested for uplift resistance in compliance with Dade County Protocol PA 124 to the calculated design pressure of the roof deck. 9. If required, any Factory Mutual Approved vapor barrier in conjunction with proprietary or approved adhesives may be used prior to the application of the insulation layer. 10. Perimeter and corner areas shall have an increase in fastener density for both insulation and base sheet in compliance with Dade County Protocol PA 117 of the South Florida Building Code. 11. All attachment and sizing of perimeter milers and metal profile designs shall conform with Dade County Protocol PA 11 i of the South Florida Buil ' g C e. Raul Rodriguez 168 7 10 0 0 ry z b C O O d. •y TJ Yq � .Or U� N w E A w � O C ..r •n a 0 v .� ., O •� td O N v O V � O C: t0 to •0 4° a° b o. 0.04 rA % O N v r'•7 .°'O. v 3 O ww.i fV .O td t1. O O V a N o fr! 0 t70 ty 4. O 4 L 0 O 1� t OVQ v ." .± y cis 3 ad 0 — L. N > O -0 u w Q V 40 N O W. 0 -d v � 4) > O N a� �S U O it ° COS O rim 0 'O td tr v O 0U -a b 0 O •O CO vcc .[ LL. M M 214 - - AOL ROOF COVERING MATERIALS MFM .OFlNG SYSTEMS ffGM— Continued Surhdrgt "Gocofisx UA•SB" Series 1 gaMn or'Gawflex UA4W applied at 1 -1/4 gWaq (12 a • dry tt►i10 42. Fe N *T�� a'Fdy4so Spy with "PoW n 2Sl" V"PWyloom 303 . 1 lm ndn Base Coen One o two applications "Gacoflex UB•7060 : appled at 1 paVsq/applieat�rt or 3 spplicatbts appBmf 1 -1/4 paVaq/sppliaation (18.32 dry mils} - 43. DSe�cica NtC "�fles U/M85' Series (vartaus a Est 1g� (12 dry mds} Rostra "Polytso � TofyIso Specs" wlth."Polyfoam 281' o "Poyfoam 303 ; 1 bt. min. Base Coat One o two appficatioM 'Gseoflsx UB 7050 . appBsd at 1 gaVsq/appBcatiort• at 3 appfiostbns sppBed 1-1/4 paVeq/applibstion (1832 dry mUs� . Surh�'Gaeoflax UA•80" Series (various eoloes) appBod 1 gsVaq (18 dry mlb} 44. F N "PolpW or Specs" with - Potyfoam 255 t' or -Polyfoam 303". 1 bt mim Brio Cost 'GaeoS5,51000' appBed at .I gWsq (10 dry mfts Surfacing: - Gaeotlex 51000'•' applied at / gwsq (10 dry toils) 45. Dodo "Poyfoain 251' or - Polytoam 303. any dddgwm 1 . Surfacing:'Gatmflex UreShiald 7007.40 dry mps. GAF MATERIALS CORP. WAYNE NJ 07470 R1308 (NJ ASPHALT FELT SYSTEMS WiTH HOT 1100127210 ASPHALT Type 62 asphalt glass mat -bow shoe, ("GAFGLAS *75 Base Sheen is a suitable aberrmte fo Type GI asphalt glass fiber ply sheet rGAFGLAS Ply 4' or -GAFGLAS 01 in the Class A:8 or C roof systems indicated below.! • : :a : t w ;• The roof deck may first be covered with a Type 62 asphalt glass that base sheet "GAFGLAS Stra. torrent (Yart•Ply) perforated" or'GAFGLAS Stratriwa(VenWivi for nallable'deeks'. Perforated to be mopped and nallabte As be medtattibally attached granule side down, As an option Type G2 asphalt glass mat base sheet rGAFGLAS #75 Base SheW w.'GAFGLAS Stratevent (Vett- Ith-for nailabla'dedcs") may ybe subskmed fof Gt•msphalt glass fiber• ply sheet Bottom ply or base sheet may be so d�motpped. spot iI oP� or'mo haan ally fastened: S -Unless otherwise. hhceated. all Insulation maybe hot mopped or mechanically fastened. "GAFGLAS Flashing' or "Ruberotd' may be used for fleshing In any of the Class A. B or C sys• : tams Bated below. When "perlite' Is referenced, this ,Includes 'GAFTEMP Parlite' or any other UL Cleasifled perllte Insulation.r ' • Crushed ston..o slag are suitable altemates•fo gravel in. am+ of the -Class A. B or C systems list., ad. Structural cement fiber building units are considered suitable to be•7nduded as a dock in the foG; lowing Class A. B or -C systems Bated over C -15/32 or NC. • • . ; : : The use of gypsum board under any of the following Class A. B or C systems does not adverseF/ effect the rating. The use of 1/2 in, min gypsum board is an acceptable alternate for insulation aver C -15/32 docks: . :. . • The use of polystyrene houladon board between min 3/4 in. podke board and dock with rosin pa- per ondlie/rosr► paper /poiystrnme/Perlite) b e suitable akemats for isocyanurate board in the fd• laving Class A. B or C systems. •.i. . Isotherm R may be substituted fo any i moyanurate hhsutetlon in am of the following Ciassi SM3 tons. CLASS A. B and C. Hot reeling asphalt, for use with organic and glass felts or modified bitumen membranes. Class A 1. Deena 15/32 0. IncIlow 3 insulation (Option&* One or more layers PerBte. wood fiber. glass fiber 100eyatxma1e, ws' thane AedlleAsocyonarate, composite, pedke/urethan composite, wood fibm/Incyanuras composite, phenols any thickness. Ply Shoes Three or more layers Type G1 "GAFGLAS Pty 4' of - GAFGLAS Ply W'. holm Swfachw Gravel 2. Deca C -15/32 Incline: 2 b"Wistion (Optional): n o or mare layers perrte. wood fiber, glass fiber, isoCyanarata tire d than• podkeAsocyanurate composite, Perfite/urethane composite. wood fr wAsocyanuras . composite, phenolic, any thickness. Ply Sheet Three or more layers Type G7 "GAFGLAS Ply 4' or "GAFGLAS Ply 8 ". Cep Sheet one layer Type 63 "GAFGLAS Minaret Surfaced Ca Shoot ". 3. Inutstlon (Opt oar* one or more layers partite, wood fiber, glass fiber, lsocyanurate ura- thane, peftaAsocyanurate composite. perfite/urethan composite, wood fiber/isocyanursts.1 composite. phenoft 2 im, max. Ply Shaft Two or more layers Type G1 "GAFGLAS Ply 4" or -GAFGLAS Ply 8 Cap Stott On layer Type G3 'GAFGLAS Mineral Surfaced Cap Sheet ". 4. Della NC inclines 1/2 5., Deck: 615/32 Incline 1 `� Slip Sheet (Optionatk pad rosin paper• nailed t6 deck: zr. _ �$ese Shsst: Ona laysr�f Tvoe G2 "GAFGLAS ��5 Base Sheet' (may be r�ailer�- _-�t - Ce a *• k�na laver of 7y `•"^�` - neral Surfaced Cap Sheet ". Base Sleet: One layer of Type G2 'GAFGLAS .jt75 Base Sheet ". ' Ply Sheet: One ar more layers of Type G 1 "GAFGLAS Pty 4' ar GAFGLAS Ply 8 ". Cap Sheet: One layer of Type G3 "GAFGLAS Mineral Surfaced Cap Sheet ". LOOK FOR MARK ON PRODUCT 9 1 6 v a57 ti E 10 3 sT Job Address: • Contractom Eff = Process No FILL IN APPLICABLE ROOFING COMPONENTS WHICH MAKE UP ROOF SYSTEM ASSEMBLY AND THICKNESS OF DECK AND INSULATION LAYER(S). (Where Roofing Component not used in Roof System Assembly, fill in with "NIA°.) e. op Ply: H1 / v w A...un:ne Mateeisl: /'7.7 ply sheet(s): 2 4!9 �• Bondizt material: ry Base sheet: /�" ri! 14 BoAft Fastens: ITo p Lays: _ inches s4„a iaattmat: • Fastener: /�� — Insulation: _ inches f ` ' ..... �.......... ........ Bonding 6Matena�d d •f � i 'J inches Gage or 2Wcknesa: D"stry, tf concrete deck: Built -Up Applications and Modified Bitumen Systems Page-4 aS7tiE ID ST Job Address: Contractor P 0 E R C. Iz Process No. / oT �?�T i Top Ply: / ©k 4 9•l9FeA,4 < "AV--919 L- (),pe and method ojattachment) �— e % �f O'r s ALT Surfacing: (Type, f applicable ) Flashing Materials: L_ (Type and method of attachment) eon rw �,►as 657,1'4 31 2- &oT1VS*rAI !Z) Built -Up Applications and Modified Bitumen Systems Page -3 - .E7AJE-103 sT. M PIERCE Job Address: Contractor Process No. i( Check'one of the following) Recover Re -roof: V New Construction !treiover, is the existing-Roof System Assembly to bas a bonding substrate ?: Y If YES, has an E907 test been carried out to confirm adhesion of xisting membrane the substrate ?: Y N erg. (If yes, attach AS7ME907 test report j Proposed Fastener. (Attach withdraw 6lstance test report. ) Has t ce k been examined for moisture ?: Y (Pr vide data confirming compliance with Section 3401.9(c) : ) THE SYSTEM: All Roof System Assemblies in the Product Approval have a variety of options. Briefly describe the Roofing Components to be used in the Roof System Assembly and attach a copy of the manufacturer's published specification: , Deck: �- (Briefly describe) Insulation: X (Type, size and method of attachment, t(applicable) f AA 4A as 47-� Base Sheet or Ply: 4 ME&N. (Type and method ofattachment) l� GOAL✓ Yt a� !/O uZCPlC [o! f ��• a Ply Sheet(s): 4,crw J, 'q -.5- + (Type and method of attachment) Built -Up Applications and Modified Bitumen Systems Page-2 • a�71v0103 S,: M PIERCE ' Contractor Process No. Job Address: . APPENDIX 'E' METRO -DARE UNIFORM BUILDINGPERNIIT SECTION II' ' BUILT -UP APPLICATIONS AND MODIFIED BITUMEN SYSTEMS GENERAL: Type of Roof System Assembly to be Applied: Manufacturer of Roof System Assembly: Product Control Approval Number: System Number from Product Control Approval: • t lYa7/��b �iT�s�ca } � Cc2�►1 y,t_ A, r BG 037510 0(o 4rrAk--A-e_b �'• �. i' �l4T�h/HCS �f� e (Attach a copy of the RoofSystem Assembly Product Control Approval and the Manufacturer's System Guide Spectfication. ) ( Note: If a minimum roof system is to be applied, describe all components within *the system and list the manufacturer of each com nent. DO NOT complete this secti>i1f yste '� Product Co of Approved. Base Sheet: _ Fasteners: Ply Sheet(s): Cap Sheet: Asphalt: O e (Note: No insulation system is acceptable under the minimum roof category. Complete the following for all Roof System Assemblies: Built -up Applications and Modified Bitumen Systems Page -1 •s UM-108 W4 DISPLAY THIS CARD ON FRONT OF JOB MLOM SHORES VILLAGE BUILDING PERMIT PERMIT # OWNER ADDRESS CONTRACTOR PERMIT TYPE ,. DATE. APR 2 7 2007 "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,- CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF_COMMENCEMENT.' CIVI L Reileh Engineering Corp. • (Consulting Engineer) P.O. Box 22011 Hialeah, Florida 33002 ENGINEER Tel:305 -823 -8008 F= 305- 823 -3300 June 13, 2007 John Busta Rogfing 300 Northeast 91 Street Miami Shores, Florida ROOF THE UPLIFT TEST REPORT Residential Home 257 Northeast 103 Street Miami, Florida Project: Dear Sirs; Information provided by client. Permit Number: R F-4 -07 -832 Date Completion: May 09, 2007 Roofing Contractor: John Busta Roofing Project Number: 07 -1782 (Testing Laboratory Certificate #06- 0501.15) In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No. 106 -- Standard procedure for eld verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof is less than 40 feet above ground surface. The type of tile used for this project was reported to be Entegra Bermuda Cedar Tan Roof Tile. This tile was reported to have been foamed in place. At the time o our inspection, the entire area of the roof was examined for loose tiles. Not less than one (1) tile in ten (10) of all components in the field area and one (1) tile in five (5) of all tiles in he perimeter and comer areas were physically examined. A minimum of one (1) test per every two (2) squares in the field, one (1) test per square in the perimeter area, ridge caps and (1) in the comer areas were conducted. Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation Mofiamad Sonny Salleh, P.E.49014 Project Manager TILE urLiff TEsr Residential Home 257 Northeast 103 Street Miami, Florida Reileh Engineering Corporation — Project Number - 07 -1782 — Page 2 of 5 Report of TILE UPLIFT TEST for Residential Home 257 Northeast 103 Street Miami, Florida Project Number: 07 -1782 Reileh Engineering Corporation — Project Number - 07 -1782 — Page 3 of 5 '` � 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass Reileh Engineering Corporation — Project Number - 07 -1782 — Page 3 of 5 Reileh Engineering Corporation — Project Number - 07 -1782 — Page 4 of 5 OiAd 25 35 Pass 26 35 Pass 27 35 Pass 28 35 Pass 29 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass 46 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass 52 35 Pass 53 35 Pass 54 35 Pass Reileh Engineering Corporation — Project Number - 07 -1782 — Page 4 of 5 Reileh Engineering Corporation — Project Number - 07 -1782 — Page 5 of 5 E Is 55 35 Pass 56 35 Pass 57 35 Pass 58 35 Pass 59 35 Pass 60 35 Pass 61 35 Pass 62 35 Pass 63 35 Pass 64 35 Pass 65 35 Pass 66 35 Pass 67 35 Pass 68 35 Pass 69 35 Pass 70 35 Pass 71 35 Pass 72 35 Pass 73 35 Pass 74 35 Pass Reileh Engineering Corporation — Project Number - 07 -1782 — Page 5 of 5 NOp M 50 29 2 229 26 10 9 8 49 n � 50 57 42 u 01 24 59 40 41 44 12 52 55 45 20 22 46 41 48 6 % yy 54 5 61 62 2D 21 57 65 19 4 14 18 64 60 58 59 60 66 69 66 16 15 69 75 74 70 71 72 I 2 5 55' 07 -1782 APPPDX, POOP T5f WCATION5 AM7171WN51ON5 . r . O !, PERMIT NO. TAX FoUO No. —M::- : :- 36 — 0 STATE OF FLORIM COUNTY OF MIAMI -DADS. =.at t c:.a• Rif • t�'7. f.: L' t 9 7 M7 : -!'• 33t 3$ -aq3 C FM 2007RO41935 ice.,, OR 8k 25566 Ps 16241 (loo) RECORDED 04/26/2.07 0 :35:01 HARVEY RUVINr CLERK OF COURT 411AMI-DAI;E COUNTY? FLORIDA LAST PATE 3. sj new sect address. o d c? ra ✓7 9.i� rdbn 259 &E-10.3 �'Sl giamilsEl 3313E—Q,430 Inienmg In property: * 111( as + � I� ilic i + + iif y:lllll•�� provided by Section 713.13(lXa)7., Rodda Statutes, Nam and addresm j ,.i al 73• `i -� i U.i; l -' 1 • • -,. t t G :^t. a - +-at a• (- a a't r. R,- a'• i,a:a k.., Il,: �,• ,e ,tai.:: Lt 1=. =--i 107-11 Mrvt Owners Prepared Sworn to and subsefted belbre me thlsQ!�L- day of 1 w , Notary Pubes Print NoWs Nam My rmmvgS!S,; n fornim.. tot fi t - sto of FWift W► N Nor mm Inspection Date: 05/03/2007 Inspector: Grande, Claudio Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: KROBOTH, PETRONELLA Job Address: 257103 Street NE Miami Shores, FL 33138 -2430 Project: <NONE> Block: Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1121360130420 Lot: Contractor: JOHN BUSTA ROOFING INC Phone: (305)757 -7620 Buildina Denartment Comments RE ROOF SLOPE AND FLAT ROOFS.FLAT TILE OFF AND FLAT COLOR THRU TILE BACK ON JI MAY 0 4 2007 � Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Wednesday, May 2, 2007 Page 1 of 2 Inspection Worksheet Miami Shores Village I rrae ... oom ,,.. _ r7 r 10050 N.E. 2nd Avenue Miami Shores, FL 1, 'Y'tAr �.f":'�✓' ! Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 05/03/2007 Permit Type: Roof Inspector: Grande, Claudio Inspection Type: Tin Cap Owner: KROBOTH, PETRONELLA Work Classification: Roof - New Job Address: 257 103 Street NE Miami Shores, FL 33138 -2430 Phone Number Project: <NONE> Parcel Number 1121360130420 Block: Lot: Contractor: JOHN BUSTA ROOFING INC Phone: (305)757 -7620 Buildina Deoartment Comments RE ROOF SLOPE AND FLAT ROOFS.FLAT TILE OFF infraction Passed Comments TIN CAP SPACEING True AND FLAT COLOR THRU TILE BACK ON MAY 0 4 2007 V Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Wednesday, May 2, 2007 Page 1 of 2 iteCelpt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: RF -4 -07 -832 Invoice Number: RF -4 -07 -28284 Applicant: PETRONELLA KROBOTH Company Name: Owner Address: 257 103 Street NE MIAMI SHORES, FL 33138• Job Address: 257 103 Street NE Miami Shores, FL 33138 -2430 Date Payment Type Check Number Amount Change Wednesday, May 2, 2007 05/02/2007 Check 4088 $337.10 $0.00 Total Payment: $337.10 Page 1 of 1 Inspection Date: 05/29/2007 Inspector: Grande, Claudio Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: KROBOTH, PETRONELLA Job Address: 257103 Street NE Miami Shores, FL 33138 -2430 Project: <NONE> Block: Contractor. JOHN BUSTA ROOFING INC Buildina Department Comments Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number Parcel Number 1121360130420 Lot: Phone: (305)757 -7620 RE ROOF SLOPE AND FLAT ROOFS .FLAT TILE OFF AND FLAT COLOR THRU TILE BACK ON JUN 1 9 200' Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Monday, June 18, 2007 Page 1 of 2 �Flfl�' .i*.. so ■ #': wimrr�ri ,.+i��ra�ri�rir��rLs iii>•rrl�i- lr #rrw�l: [1< iR�iiinu�iii lrrrrnnuiut�riirnii�in ■iiinifruir>t rsiirnl iriiuin�? •• ��_ �>. rr�tNrss lsislN�wiiliuisuM)r�i #iiininsl lssrrrLll�rii��,s [ 1 �.4 :19 f`i'atar m t ! _mss .ter 1 ... awsunrnnrrnis�'�rriii IirliS 4 i1- 1i ■� 11 11 � ru °.4AIk 1 i '%ui lg;6, •r �,`lilAUilt ■iiiltiirNisu \.'s un lmr Ai i •�•r�,xrs�Rxtr�trn>si M61' At ssM�linr ><iisiiiriri►.nri>��..o>.MI .,-i:_ .�. . _.srlltil'iR11� iK�1�11RiRiii.'� �' iiii>s3 fnni�liiinuAt�rn,r . r.. •..r ■riii!•ulu +I� t .. IZNYnF�- iirrRru.! r.:! rx�rliiiil��� !!�iirrrrjwi>t!ritwl: • ►•- 4oriinr� Mingnururrrir/lrrinniiiriniM __.._ luissnisuiss ew.an,aIIWo itilririiiliil(iiiirl. 1 !+[ nil' �4nniisix�ll �Aiifir' iwRr/ i�liiiiliiri 'ii / \ii,il�lilllrriiirilMrl .. ; .:rinliuonwo; ,a�i?��airirn,., roc. :m!Innamananonnwoos ar>rr.iinrQl' Itl[ t11.`t �t lT�! Puil! Xiiii l9/ / %r "i�IR11111�. /u1Yl�I'�:i ■ w• will Iiisauftilii• i�iriil� %�s�a'irli�►/iUNotlt■ snsiASirr>•>Aammm.. •a'rrte wil tlliTi�AA us;;; nniuirslfnn wxAARdQ9jk a`IkVIII-mli, �. sun so iIM!MS7 isfMss7niu'Momox /''WHMIs1MM1M Design VrAd Pnwmavm6 Fmm RAS lMarCWWukdom 17�77W#777-11- 777777 f*wabwotFa9hmmovsP*rkmdmftn 'Dowd F%Od. WA—r- ,now wk c mw air Rai Tqa U A TOP ble"1100on 0 lif& I if foy a l4iej -,Vplysbo$"At&.Gtpw w s Y Ojes I t ToPPIFFedensdo T11'= i- �A M-048 AM PAGE 3 Ocill G -AP C>4,21,S -1-i,n 4cappt?,d w / 47,41 Vj 0i rr7w-qlv 51 •i2 9 1V or * P3_ -- loo. 6 W Tw£ M E f # #W PERMIT NO. TAX FOLIO NO. l�°°��6 STATE OF FLORIDA: C,01JNlY OF MIAMI -DADE: THE UNDERSIMED hereby given notice that Irnprovernentss will be made to CWtOlSn rat property, and In accordance with Chapter 713, Florida Statutes, the folloI Inforrnation Is provided in this Notice of V !,'T •� !. '! R ],� OR Sk 25566 P9 1624; (log) RECORDED 04/26/2007 09:35 :01 HARVEY RUVINr CLERK OF COURT IIIANI -DARE COUNTYr FLORIDA LAST PAGE 3313g _alt3 p P /03 54 Miaml r.FJ `7 /0.3 - I- IiCOrfi d A 1 r_.� AW <4 .le/, : x 6. Surety:. (Payment bond required by owner from l a Name and Addresr. Amount of bond r Lenderls name and address: 1 A 7. Persons G state of • ,'i designated by Owner upon whom • other documents may be served u• F:. provided by Section 713.1 3(l)(a)7., Florida Statutes, Name f address. i t 1 8. In addition to himself, Owners designates th e following person(s) to mceive a copy of than Lienorls Neff as provided In Section 713.13(l)(b), Florida statutes. • 77 1..:R •.er= R_. i!- -cY •T: }' Rs 1 • .• ... Y �,_ • - o:NR. ..• �f F NOW It R 7771 k 4-1 EL4W l� f y Q ��`3lll R � "•:t M r -1 •� �.?. � ��� ,11.1..:'.;(1: } � f . ;i SECTION 1324 HIGH VELOCITY HURRICANEL ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS r lai a59 0E 1o3�4 Property Address Permt Number Rent/ S, raw I .A LyT� Ma 1361 A% Road Wayne, NJ W490 L� �. � 1• N_ 1 J'f f ATIV 41; - �, r 1" 1 1 '111 iiii ii t it 1. l? l. - INSPEM iNs A copy of this entire NOA shall be provided to the user by the nm&cW= Or its di�"OW= and shalt be available for it on at the job site at ft request of the Building Official. This NOA renews NOA #02-04M 10 and consists of pages 1 tbrou& 31. IU submitled 'on was reviewed by Frank 2nlongs, RRG a t �• ! aL to I�YU,w' r „l lit _1 C, :11'1 :.ir• -� F_.. I.:c:_f 1.; .:.1.111.:. t • 1 "I:: �. 14iF 4it:11t. �• 1' i1 il;i:tiYt .' i ..rC.x wi i• ".t,, � 1 111 1i i. f'! - +Y F;11 =_:. 11111 "- Ilr %tl•:•.l. �iL`1_ rF” T:=F fir'. ice._ It I s � \T t 7 l 111 1; +•!IIG. f�{ Mj J j oil ,1 va It 1._ «,;¢ 1 7F.. •.: :1 }i 1, ,..:,. ,.. .4 {'{• _y, L4sW GAFGLASOPMhWg i. n M a O if ti it I}': do . 11:I:a_ STRATAVWM r,'. EfiMhWWpafUWBd .,i.: ;. ,. Mi- 11O SW Bat. I mew (39-VI Warm smooth wwo : �+� ib - SUS :c Y meta f 1 1 -i.. Wide RUM OM SBS , W- I meW (393n WeUM i.. , ,:° 39,3r (1 ) , WdIMPLUS l Rmaxome R - -A.•43. - f S K Cea Weld PUIS PR WW 1 . MkOW .. tll d, = mN [.. i +' ,: . -ar- -- Type G2 BUR ASTM D 3019 Type M ASrM D -6164 3937" (2 ) AMU D 6222 w1we ASrU D 5247 1 sq. ton ASTMD 6 57 tbs. AMU D 5147 3937" (1 nx) ASTM D 6164 wMe ASTMD 5147 39.37" (1 ) AS M D 6164 vtls ASM D 5147 39.37"' (1 mew) ASW D 6164 wwls ASTU D 5147 39,3r (1 ) A U D 6222 WI ASTM D 5241 M& NO: 1 p"P30C32 M I(- - --�• -� 1 YII tl,,l,•1 ! h�i _lam- - r - �. 1 1 7 Y II`il u1 1 -t t.J ` .r Ik {,1f S,.t ,nit ii.fl �IF:u'A. i 4 r2 4:t. TV �' Li;lay II`s>T_ #" f.f %: l), : . -41.. �lll.l -4i I. :l1iY ;. v'v'i ijf- �).i ►'. ' ,•. };_ ar; il::atf Ci! <i ll:ff'It tl. - `i Tlt a •. f f. ,1 �. )11. ':rl ,4'11 }I.��4 �7 t. . ?.i le: - - =. i1 .9rltt R 4 I.Y.. d'..1��. -t , ilf: - ,I, Ito iT Iif ( tAtl'_ ' � ;544 <. i Y• t ' 4�1:.:+: .�. 'ri. i 1. Itr ... \. ., - r "!. L1 171 it1111,11! ulr:!llli .ej c �l ��.II 4 Ord .1 -'3 :111 4 1V1 �.I'(!•i -A -. Yr.�.T - YIf NJ MIMI, 14IIfi,'-�11 � 11,ll� II ArMOVEDIMULATIOM: TABLEZ Ill mll ctvm \ ( Cwmwt NOA) GAP Mated* Cam. GAF Mawt b rorp- xM*o O&LAP no W Materials cavg (BMC1A) nAPT ugh wood f1 Density Fibaboad BMCA. RA PolYtsa� inst�tlattan BMCA Cmpo*e ftaUG p gpMIWOW f RA mite Bma h� gaftwic ().P GYPSUM Corp. JdbmMMVMIP 14QA ilk: M DdW- 1 AffnvdDaWIWIW pW64'32 TA.KX B prodad DawAlfift Mhautfareturer (With G'urvnt NOA) Je►hms minme Jobna MOM Ble PJAM Inc• Pam hr— t9 FAgTs: TA,uzu 3 F Pry l (wa Carted 1OA) Number 1. Nam G�AFi1 M (DIM -TOO) for GAP ° #12  Heavy , wOA F s C q),. I OAFMO MdB- Teri) AS" ble tOA I (DE&TWO) Plates- B� soet f Ci�iF at BM Siod Fastem and assembly. 4, uwa Platte t'�- R nM strm 3" and 3'l�i" OAF is ° T Pte° 3° and 3 W GM CO'P 5. 1"1 "( Ted gam' DekbA F #M #14 f( au F Inc &M wood, steel and concrM 7° Hex Plate dwks C�lval a hex stn s plate• Z'i/rx 3 VP C wdOnFawten Inc. �. I� 3` x 3A plate. for ITW Buildex COIP. 9. #iZ Ruofpitp Fistenets 108010biOu fastener and steel. 3r ry�.�/������ BuDdex //''''1� Cp° �� 10. mew Plate 3„ ire 3,X .a � B!m'�ex Cep• 11. 12. Gashistftstem . f- rN.i 1 .,it' Y �r Jcbus MW VMe t APMOVWIFASTENM: TABLE 3 � t�aL -OVM* maufactaft 13. Oly is x #12 & Inalsfim Group, Tr. #14 14. O , Inc. Olyos POI mmimPoly�Progyl p� p pig 3.25" round Olym*' 15. 16. OIympic l-2 3.5 3.5° Olym* Imo. AZ55 Md Oft r wood Vk,.hm AZSO 3" 17. 1 Phft SiStadles 1S. itl -14� ftn I ad vwoW mks 3« ri gaivalum� AZ50 � 3" n 19. 1�at -"�. S m1 3« far 20, i P 3 « p la for md The Tv&vast Cam- 21. TTi -fit ,dwb 3« rotimd AZ55 3" a 'h Ts�x �, Trar-Fast F"iaoee swdpko 3« The TM -Pad Cw$- 23. TrwFast PI sgJ9li►11'ifilGO: MOLUM ` pMC 1996 0101.96 P Mill ° Raq pacM umd FMRC 4470 -PA 114 J.L 1B9A8.AM 09.04.97 J.I.3D4Q2LAM 04—VP 9 Uplift PA 114 4483.04 97 -1 06.06.97 Titer 07.01.02 Fps Aspbak Tedmdwglm be. 02- TAS 114 01.18.02 IRT of S. R. 02 -04 TAS 114 03.2 02 lRT of & FL . NOA No: WAGOIX Dam: IIMM «. � � rat8d32 k AM �E .� t�ii ! -� ��l. L �' � 1 i; r i 1 �: Y0 00D Dim SYffrMM LUMATIONS: 1 A slip sheet is xauired with Ply 4 and Flu Ply'" 6 when used as a mechanic aUy fastewd base or anchor sheet. 7. Wkimum VC Dew Dock or % Type X gypsum board is affable to be insta W directly orrer the wood dock. TGFU.R1306 -Roofing Systems Page 10 of 49 14. Deleted. 15. Deck: C -15/32 Incline: 112 kwuiation (Optional): -- Perlite, fiber glass, Isocyanurate, urethane or periite/Lsocyanurate composite. — One or more layers Type G2 "GAFGLAS #75 Base Sheet" or Type G3 "GAFGLAS Mineral Surfaced Cap Sheet ", hot mopped or mechanically fastened. Ply Sheet (Optional): — One or more plies Type G1, hot mopped In place. Qembrane: — "Ruberoid Mop 170 FR" or "Ruberoid Mop FR ". 16. Deck: C -15/32 Incline: 1/2 Insulation (Optional): — Periite, fiber glass, isocyanurate, urethane or periite /isocyanurate composite, offset 6 in. from joints. Base Sheet~ — One or more piles Type G2 "GAFGLAS #75 Base Sheet" or Type G3 "GAFGLAS Mineral Surfaced Cap Sheet" , hot mopped or mechanically fastened. PiY Sheet (Optional): — One or more plies Type G1, hot mopped in place. Membrane: — One ply " Ruberold Torch Smooth" or "Ruberoid Mop Smooth ". Membrane: — One ply "Ruberoid Mop 170 FR" or "Ruberoid Mop FR 17. Deck: NC Incline: 1 Insulation (Optional): -- Periite, fiber glass, wood fiber, isocyanurate, urethane or periite /isocyanurate composite. Base Sheet: — One or more layers Type G2 "GAFGLAS #75 Base Sheet" or Type G3 "GAFGLAS Mineral Surfaced Cap Sheet ", hot mopped or mechanically fastened. PlY Sheet (Optional): — One or more plies. Type G1, hot mopped in place. Membrane: — One ply "Ruberoid Mop 170 FR" or "Ruberoid Mop FR ". 18. Deck: NC Incline: 1/2 Innsulation (Optional): -- Periite, fiber glass, wood fiber, isocyanurate, urethane or perDWisocyanurate composite. Base Sheet (Optional): -- One or more plies Type G2 or G3 base sheet, hot mopped or mechanically fastened. Ply Sheet (Optional): — One or more plies Type G1, hot mopped In place. Membrane: — One ply "Ruberoid Torch Smooth" (smooth), "Ruberoid Mop Smooth ". Membrane: — One ply "Ruberoid Mop 170 FR" or "Ruberoid Mop FR "_ 19. Deck: NC Incline: 1/2 Insulation (Optional): -- One or more layers periite, glass fiber, isocyanurate, urethane or perfite/isocyanurate composite, any thickness. Blase Sheet; — One or more plies Type GI "GAFGLAS Ply 4" or "GAFGLAS Ply 6" or Type G2 "GAFGLAS #7S Base Sheet", hot mopped or adhered with Karnak Chemical "No- 81" or Gibson -Homan "No. 6160" cold applied adhesive at 1 -1/2 gal /sq. Membrane: — One ply "Ruberoid Mop 170 FR" or "Ruberoid Mop FR ", hot mopped or adhered with Karnak Chemical "No. 81" or Gibson -Homan "No. 6160" cold applied adhesive at 1 -1/2 gal /sq. 20. Deleted. 21. Deck: C -15/32 Incline: 1/2 Insulation (Optional): --- Polyisocyanurate, wood fiber, periite; glass fiber any thickness, hot mopped or mechanically fastened. Base Sheet: — One or more plies Type G2 "GAFGLAS #75" base sheets, hot mopped or mechanically fastened. Membrane: — One or more plies "Ruberoid 30 FR" hot mopped in place. 22. Deck: C -15/32 Incline: 1/2 Insulation (Optional): — Polyisocyanurate, wood fiber, periite, or glass fiber any thickness, hot mopped or mechanically fastened. Base Sheet: — One or more plies Type G2 "GAFGLAS #75" hot mopped or mechanically fastened. Ply Sheet, — One or more plies "Ruberoid 20 ", hot mopped in place. Membrane: — One or more plies "Ruberoid 30 FR ", hot mopped in place. 23. Derck: C -15/32 Incline: 112 T11 N,4 WA141I DADE COUNTY, FLORIDA METRO -DADB FLAGLER BUILDING BUMBING CODE COMPLIANCE OFFICE (BCCO) 149 WEST H AGLER STREET, SUITE 160 PRODUCT CONTROL DIVISION WAK FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375-2908 NOTICE OF ACCEPTANCE (NOA) www.buitdinerAdeM%'ftnndb mmuss Entegra Sales, Inc. 819 N. Federal ED&way, Suite 300 Stuart, FL. 34994 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 (W. This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AM (m areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Cade, including the High Velocity Hurricane Zone. 1)ESCRwn0N: Bermuda Concrete Flat Road The LABELING: Each unit shall bear a permanent label with the manufachuer's name or logo, city, state and following statement~ "Miami -Dade County Product Control Approved°, unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMIIVATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process, Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically 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. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This replaces NOA # 06- 0610.06 and consists of pages 1 through 6 The submitted documentation was reviewed by Alex Tigera. —ft In NOA Na 0640606.05 Date: 06107/11 Approval Date: 0 INM Page 1 of 6 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE This revises a roofing system using Entegm Flat Concrete Roof Tile, as row9aChned Entngra Roof Tile Corporation described in Section 2 of this Notice of Acceptance, designed to comply with the Florida Building Code, 2004 Edition for High Velocity Hurricane Zone. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the design pressure values obtain 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. 2. PRODUCT DESCRIPTION Iisanufactured by Test Product Annlicant S Cations Desaiption Entegra Flat Tile 1 =16" TAS 112 Flat profile, interlocking, high pressure W= 10" extruded concrete roof tile equipped with 1 -c/" thick two nail holes. For direct deck or batten nail on, mortar or adhesive set applications. Trim Pieces 1= varies TAS 112 Accessory trim, concrete roof pieces for use w = varies at hips, rakes, ridges and valley varying thickness terminations. Manufactured for each tile profile. 2.1 COMPONENTS OR PRODUCTS MANUFACTURED BY OTHERS Rainproof II Ice and Water Shield 30" x 75' roll 36" x 75' roll or 60" x 75' roll 36" x 75' roll �1 TAS 104 TAS 103 07 IAf,I Single ply, nail -on underlayment with 2" self - adhering top edge. Self- adhering underlayment Protect-0-Wrap, Inc. (with current NOA) W.R. Grace Co. (with current NOA) en- NOA No. 06-t .q5 Expliuden Date: 06d'l1I1 Approval Date: 07MM Page 2 of 6 a { NOA No. 06-0606.05 KVhWrmn Date: O6l0MI Approval Date: 07/06106 Page 3 of 6 Test Product Produ ons S htions Descriptiou Manufacturer Wood Battens Vertical Wood Preservers Salt pressure treated generic Min. l "x 4" Institute LP -- 2 or decay resistant Horizontal lumber battens Min. 1 "x 4" for use with vertical battens or Min. l "x 2" for use alone Tile Nails Min.10dx 3" TAS 114 Corrosion resistant generic Appendix E screw or smooth shank nails Tile Screws #8x 2 W long TAS 114 Corrosion resistant, generic 0.335" head dia. Appendix E coated, square 0.131" shank dia. drive, galvanized, 0. 175" screw thread coarse thread wood dia. screws Roof Tile Mortar N/A TAS 123 Prepared mortar Bermuda Roof (`"TileTite?A1"} mix designed for Company, Inc. with mortar set roof tile current PCA applications. Roof Tile Mortar N/A TAS 123 Prepared mortar Quikrete ( "Quikrete® Roof mix designed for Construction Tile Mortar mortar set roof tale Products with #1140 ") applications. Current PCA Roof Tile Mortar N/A TAS 123 Prepared mortar W. R. Bonsal Co. ("BONSALO mix designed for with current PCA Roof Tile Mortar mortar set roof tile Mix ") applications. Roof Tile Adhesive N/A See PCA Two component Polyfoam Products, ( "Polypro® polyurethane Inc. AH160 ") adhesive designed for adhesive set roof the applications. Roof Tile Adhesive Factory premixed See PCA Single component Flexible Products TileBond canisters polyurethane foam (with current NOA) roof the adhesive a { NOA No. 06-0606.05 KVhWrmn Date: O6l0MI Approval Date: 07/06106 Page 3 of 6 Tat Product P� Di Le—ndm cations Ablation MwVfwcturer Hurricane Clip & Clips TAS 114 Corrosion resistant Generic Fasteners Min. W' width Appendix E clips with corrosion Min. 0.06(Y" thick resistant nails. Clip Fasteners Min. 8d x 1 y" 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certufied Laboratory to perform quarterly test in accordance with TAS 112, appendix W. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum undedayments shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30M 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 compliance with applicable Building Code. 4. INSTALLATION 4.1.1 Entegra. ` Flea' Concrete Roof Tile and its components shall be installed in strict compliance with Miami Dade County Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w) Tile Profile Weight W (M) Length -1 (it) Wlaui f r (ft) 1 Entegm Flat Tile 9.7 1.33 .833 Table 2: Aerodynamic Multf liars -1 Tile Profile -% (f0 Batten Applicatio n 1 2, (fla) Direct Deck ApplicaHon Ent® ra Flat Tile 0.189 0.205 O � NOA No. 064)606.05 Expiration Dot= 06/09111 Approval Date: 07!06/06 Page 4 of 6 Table 3: Mofnettts due to Gra - M -1 Tile Profile 3 °:12° 4 °:12° 5 °:12° 6 °:12" 7 °:120 or 9 rest®r Entegra Fiat Tile Battens Direct Deck Battens Direct Deck Batters Direct Deck Battens Direct Deck Battens Direct Deck 6.53 6.97 6.43 , 6.86 629 6.71 1 6.14 6.54 5.97 NIA Table 4: Atlachrrmnt Rest Expressed as a Moment - Nh (ttdbf) for NO-On System Tile Profile Fastener Type Dot Deck (min ISW plywood) Direct Deck (min. 19132" plywood) Battens Entegra Flat life 2 -101 Ring Shank Nails 30.9 38.1 17.2 1 -10d Smooth or Screw Shank Nail 7.3 9.8 4.9 21 Od Smooth or Screw Shank Nail 14.0 18.8 7.4 1 #8 Screw 30.8 30.8 18.2 2 #8 Screw 51.7 51.7 24.4 1 -10d Smooth or Screw Shank NaN Reid C 24.3 24.3 242 1 -10d Smooth or Screw Shank Nail Eave Ci 19.0 19.0 22.1 2 -1 Od Smooth or Screw Sunk Nails Feld Clip) 35.5 35.5 34.8 2-1 Od Smooth or Screw Shank Nails Eave CI 31.9 31.9 32.2 2 -10d FUng Shank Nails 1 50.3 65.5 48.3 1 installation with a 4- file headap and fastemem are located a rNn. of 2W fray► head of tile. Table 5: Attachment Resistance Expressed as a Moment I& (ft4bf) for Two Aft Adhesive Set Tile Tile Application Minimum Attachment Resistance Profile Entegra Flat Tile Adhesive 31. 2 See manuiac Lures component approval for instaiiatim requiremerft. 3 Fey iWe Products Company TflseBond Average weight per patty 13.9 grams. Inc. 6nME weWd per patty 8 grams. C, NOA No. 06- 0606.05 Expiration Date:- 06ffffU Approval Date: 07AW06 Page 5 of 6 Table SA: Attechumd Resistance Expo as a 11 bMwd - W Tile I Tile Applhmtlon Entegm Flat I PolyproTM of 24 S. LABELING Ail 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 61 Application for building permit shall be accompanied by copies of the following. 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. PROFILE DRAWING ENTEGRA "FLAT" CONCRETE ROOF TILE I r 16' -1 1- -17/ -4'' i 10' r T- 2. --- ---16' _i OF END OF THIS ACCEPTANCE Aft NOA N& i i l i -1 I Mw ef IN FXPkR*AD0K 41 ,i. w App ro val Dote.- i KM MIAM =in% BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam .Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY, FLORIDA METRO -DARE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (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 the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The BCCO (In Miami 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 manner, the manufacturer will incur the expense of such testing and the AM may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polypro® AH160 RENEWAL of this NOA shall be considered after a renewal application has been Bled and there has been no change in the applicable building code negatively affecting the performance of this product. TERKMATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically 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. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA No.0 1 -0521.02 and consists of pages 1 through 7 The submitted documentation was reviewed by J rge L. Acebo. NOA No: 06- 0201.02 a (''Expiration Bute: 05L10/11 Approval Date: 04 /13/06 Page 1 of 7 ROOFING ASSEMBLY APPROVAL: Category: Roofing Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves Polypro® AH160 as mamif tetured 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 PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Polypro® AH160 N/A Foampro® RTF1000 N/A ProPack® 30 & 100 N/A Test Product Description Specifications TAS 101 Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro AH160 roof tile adhesive. PHYSICAL PROPERTIES: P10 119M Test Results Density ASTM D 1622 1.61bs. /ft 3 Compressive Strength ASTM D 1621 18 PSI Parallel to rise 12 PSI Perpendicular to rise Tensile Strength ASTM D 1623 28 PSI Parallel to rise Water Absorption ASTM D 2127 0.08 LbsdFe Moisture Vapor Transmission ASTM E 96 3.1 Perm /Inch Dimensional Stability ASTM D 2126 +0.07% Volume Change @ -40° F., 2 weeks +6.0% Volume Change @I WE, 100% Humidity, 2 weeks Closed Cell Content ASTM D 2856 86% 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. NOA No.: 06- 0201.02 Expiration Date: 05/10111 Approval Date: 04 /13/06 Page 2 of 7 EVIDENCE SUBMfMD: Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -IPA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25- 7438 -4 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB-589-631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[l] ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10 -1 520109 -1 TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 TAS 101 03/02/99 520109 -2 -1 LEWFATIONS: 1. Fire classification is not part of this acceptance. Refer. to the Prepared Roof Tile Assembly for fire rating. 2. Polypro@ AH160 shall solely be used with flat, low, & high tile profiles. 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of Polyprog AH 160 roof tile adhesive with their file assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein i �F` W F= MS Q NOA No.: 06- 0201.02 I KVirationBate: 05110111 Approval Date: 04/13/06 Page 3 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nail through plastic cement W Nail through plastic cement Single paddy under file (between tile) • Underiayment Single paddy between tile Paddy 2 in. x 7 in. medium (under tile) size paddy eave 0 ° course only Slagle paddy ��in. under file PlIn. x 3 in. x 3 in. 4 in. Single paddy on 2 in. Single 2 in. under- ° paddy on layment under - layment Single paddy Fascia e course on top of file Weephole Single Ply 2 is X 7 in. medium fa" Eave closure on top of the size paddy eave Cam Fascia course only Ddp edge Nail through plastic cement Single paddy under file Single paddy between tile r �'-'3 in. x 3 in. 4 in. Single paddy on undedayment 2 m. Single paddy Eave Closure on top of tile 2In. x 7 In. medium Eave Course size paddy eave course only Fascia END OF THIS ACCEPTANCE NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7 MIAMI SHOES VILLAGE, FLA. N'? 6109 JOB '�- a -- — ADDRESS Z 4-7 INSPECTION F—Oe �.— i 'Jr 'i TIME READY kk--,k • ~ /C REMARKS: INSPECTOR MIAMI SHORES VILLAGE, FLA. DATE N? 6158 JOB ADDRESS INSPECTION .J .4 TIME READY -- J REMARKS: INSPECTOR DATE ADHESIVE PLACEMENT DETAIL .2 SINGLE PATTY Nail through plastic cement Paddy (Beneath iris) Nail through plastic cement Paddy (Beneath file) Underlayment . � Underlayment 1 I 7 in. i 2 in. 7in. im Eave Course Fascia Fascia Weephole Eave Course Eave closure Eave Closure Drip edge Nail through plastic cement Ply (Beneath Tile) Underlayment 7 in. i.e in. Eave Closure Eave Course Fascia NOA No.: 06- 0201.02 Expiration Date: 05110111 ' Approval Date: 04/13/06 Page 6 of 7 t td a MIAMI WORES VILLAGE, FLA. N° 6144 JOB c, � L -- - -- - — ADDRESS = 7 N C ! oz' — INSPECTION - -D� �+- �. �� , (3 i A) TIME READY REMARKS: INSPECTOR Gtr MIAMI SHORES VILLAGE, FLA. DATE N° 6048 JOB k.0 -a c y _ - - -- — ADDRESS L a N- 3 INSPECTION TIME READY 'Alflff' J REMARKS: F INSPECTOR DATE Nail through plastic cement / UnderlaymeM 10 in. Eave Course Eave Closure ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY (beneath Tie) j fascia F�a couae only; Keep adhetire approx. 4 in, up from rreepholes Nail through plastic cement U at 10 in. n Ea* emu Eave course only: Keep adhesive approx. 4 in. up from weeps ales Paddy (beneath rile) Fascia Weephole Eave closure Drip edge 1) Place enough aftsive to achieve 17 to 23 Optional 2x rs for square inches in contact with the pan fi*h, steep pitch alications Nail through plastic cement 2) Turn covers upside down. Place adhes To 1 in. From outside edge of cover file Then instal the tile. Undertayment 1 ° of the eave Sheathing course cover tile. Abut to second course of Optional pan ties. Ensure eave W d pan and cover files are Point -up Mortar Rush at eave fine. on longitudinal edges of file Eave closure Weeptwle Fascia (mortar shown) NOA No.: 06- 0201.02 Expiration Date: 05110111 4 Approval Date: 04/13/06 Page 5 of 7 MIAMI SHORES VILLAGE, FLA. NO 6075 ADDRESS INSPECTION o TIME READY T REMARKS: @ K 9 INSPECTOR J DATE O MIAMI SHORES VILLAGE, FLA. N. 6092 JOB ��— - - - -- -- — — ADDRESS .Z �� �� l4 3 — INSPECTION TIME READY �?�a `; J — REMARKS: INSPECTOR y DATE '�� INSTALLATION: 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. 2. Polypro® All 160 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 3. PolyproO AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. PolyproO AH160 Operating Instruction and Maintenance Booklet. 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. 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. 6. Polypro® AH160 shall be applied with Foampro RTFi000 or ProPack® 30 & 100 dispensing equipment only. 7. PolyproO AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic the profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Single Paddy Two Paddy Weight Detail Weight Min. per paddy Min. (grams) (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece #1 17 /side on cap and N/A Barrel) 34 /pan Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 g LABELING: All Polypro® AH 160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. C:G NOA No.: 06- 0201.02 Expiration Date: 05/10/11 ! WE Approval Date: 04 /13/06 Page 4 of 7 M 2 MIAMI aHORES VILLAGE, FLA. No 6088 JOB " A ADDRESS INSPECTION S L A !3 TIME READY REMARKS: INSPECTOR DATE 0_ MIAMI SHORES VILLAGE, FLA. N? 6120 JOB tdZi /Oro F OF ADDRESS INSPECTION T-a �r� - r J _ TIME READY REMARKS: INSPECTOR DATE +'4 •:!�f tfA: { Jld/ �� r /'" V F it �1��F Y!' f�. ,. - iF : ...0 s i u¢ y 14„" °r!N • ,ff 1r.'o4GlN' � ' 1 -. jai ;•. cs°"�y.. ice'' ° ,; •it ,0 4 '' K Mme: i ✓0 * , *,- f '16 At onk % , I -IF -7 !F/�'. A W , ba-� p ,� �� �� - // CFO 7 �3z %5717 VF- 103 6:7- c, "i *//vlga-v% �&6. � Miami Shores Village O� PlCb.� g Building Department jj� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING _.� __ , ,' ! �c �i Permit No. PERMIT APPLICATION APR 2 6 20071 Master Permit No. FBC 2004 B Y:.! !ate __._.,__ Permit Type (circle): Building Electrical . Pl umbing Mechanical Roofin Owner's Name (Fee Simple Titleholder) Ro6e(4 d- "R-troodla K(-fibc-� Phone # A6DS) r;753 17 Owner's Address 0? S ? &)P City M 1 aM i State j Zip 33) Mr cq 13o Tenant/Lessee Name V A Phone # /V 1A Job Address (where the work is being done) (95% ME: /03 34 City Miami Shores Village County Miami -Dade Zip 'f30 FOLIO / PARCEL # Is Building Historically Designated Contractor's Company Name Contractor's /Address City 'v' 1OM l Qualifier Name State Certificate or Registration No. YES NO J0I 4& Ss 61 o f T 3®0 N &_ Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Q a Type of Work: Addition Describe Work: Ke State F-1 Phone # % , '25 �G3.O Zip, Phone #OS� Certificate of Competency No. S,9uare�} .1 QNew d onrl Of Work: M Repair/Replace -,6A T711) 4 ❑ Demolition Submittal Fee $ Permit Fee $ 6 CCF $ ,ZQ CO /CC Notary $ Training/Education Fee $ ant) 4,40_ Technology Fee $ —7 50 Scanning $ Bond $ Structural Review. $ Radon $ DPBR $ Code Enforcement $ Zoning $ _ Double Fee $ -^� V)� i Total Fee Now Due $ 1 • i C�' o 2 rte, See Reverse side --> Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if Mortgage Leo ., r Address n City State 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 IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature / Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20C, by e b( y �i'. day of A l 2V> , by who is personally kno to me or who has produced who is personally known to me or who has produced w ro As identification and who di ,an, identification and who did take an oath. Ot�Y pV6 ' LOfERAINl -�C NOTARY PUBLIC: 'r _ Notary Public '1�1 Pf" P BLIC: • MY Commission Expires Apr 16, 2010 Commission # DD 520488 Bonded by NOWW Notm Assns i Sign Print: Print: My Commission Expires: ( ^'� i 1 My Commission Expires: ( ( 4 L APPLICATION APPROVED BY: /%/" i Y/ -AW /o / Plans Examiner Engineer Zoning (Revised 02/08/06) r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address .2 S 7 AJZ-_/0.3 sT Tax Folio �� ' o� 13 C> % 3 - O `- a eD Legal Description / Historically Designated: Yes No `C - essee /Tenant k�¢6ef -T �i� -e,6 0 7-G. Master Permit # 3 % Owner's Address 3 3 / 3 8 _c� % !V lD 3 sT /s'%i.�Hi dos 5 Phone 7 Zr, _3 % Contracting Co. _ r' (�, e r r-<- - - n_1 Address /$�i !�' J2_ ,29e A,Y 141,14 ;r �L- ,� � 32� 7g Qualifiers t- v i t e t G �- SS# `� - oe ZSIo 0 2 0 9 State # �� ® O q ;Z g / Municipal # 30- ;Z 9 Saz O / 1 Competency #fie 44700 1 Q 7 9S Ins. Co. -7;1-1 rsel rs Architect/Engineer Address Bonding Company Mortgagor Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION _ w 7 i 4 Z Ae F n a l /4 AV T 14ee ®•v �oy� F r�s ICJ/ -y /�, C of Square Ft. 9Q0 Estimated Cost (value)'" ¢ SD WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner d/or Notary as to Ovp My Commission o President Date Fflbli,e 0 ar Florida lat w Canwissw spires June S. 1897 Si e o ontrac or or weer -Build Date Notary as to Cont4ablor or, wn �ui a Date My Commission xpires: ryuGiic,e of Florida at lard c4aw"10 DPW" Jun 4% 193Z FEES: PERMIT p • RADON C.C.F. / • NOTARY TOTAL DUE APPROVED: Zoning Building X7 Electrical Mechanical Plumbing Engineering ,SNpg�sy • • • ••• • • • �� . :.::: :.: • PERMIT APPLICATION -°` Master Permit No. ... Subs;diaj;Per iit�Tp.: •. • INSTRUCTIONS - The following steps must be taken to obtain a permit frorn the Nliarni Shores Village: Step 1. Complete the attached permit application which must be signed by jk8 ro'eriv owner andoiVilien Bo th signatures must be notarized. Please print or type to allow for a more accurate processing of your application. ; :od:mj v:%f wali be dint, a roofing application must be submit- ted along with this permit application. 00" • • • ' ' ' ' 0 0 0 0 ' Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. F 52 Ayf, /6 3 s i Address Apt. City State Zip Folio Number description of Work Lot Block Subdivision PB Current Use of Property_ Proposed Use of Property Tenant Information PERMIT TYPE( ) Buildin Electrical Mechanical Plumbing LPGX Roofing Fence ARCHITECT Name License No. Address Telephone Fax PG Zoning Linear Feet Square Feet 96 Units Floors alue of Work Bldg Value T Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension PROPERTY OWNER e 20116W k904607274 Address �nlA�v7N6� �G X313 Home Telephone Business Telephone 3or -7 e°df Fax Ems✓ / TYPE OF MANAGEMENT (./) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'1 Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 ; • PERMIT APPLICATION .... ....... . IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK W"O1UT'•I-IAVIN'G•REJEIVED:YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS 00F CONMC41 IAN are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas VVST J3JyMAVJTAIV EDI NA LEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PRQPERTJP�S 1HILB BE K-EPW FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED rROM BLINO0HAM.4GEDD BYEQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street19idevmYc: : : ' 0 ; ; • . 9 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 151 Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE O I A, C UN Y OF M I- E Signature of Owner M,� Wt Name wom to and subscribed before me this 1z "day of - r A,?- of Notary SEAL: Personally known OR, Produced Identification i 2064 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of of Notary Public - State of Florida Personally known Type of Identification Produced: Type of Identification Produced: OR, Produced Identification Page 3 • . . • • • • • • • ' PERMIT APPLICATION 11 INSTRUCTIONS: Please indicate the type of work being perform¢d an j gnpiity(iisxirl toe space provided below. I ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outl4, 4p f jli64 • • • . Service Repair Heating Strips, each A/C Central 1-3 Ton Bath Tub Fan Dryer Vents, Number of O&Iet,-*aft Service, Temporary A/C Central 4 -7 Ton Ductwork, Cost of Fire Pump Periodic Inspections Outlet, Switch Signs Fire Sprinkler System A/C Central 8 -15 Ton Sprinkler Repair Fixture - Fluorescent Bath Fan - Vented, # Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs Gas - Appliance A/C Central 20+ Ton Pump, Domestic Flood Lights Supply, AC Well Plugmold/Stnp Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Catch Basin Air Conditioners Gas - Propane Garbage Disposal Pump, Re- circulate Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Urinal Clear Violations Dental Chair Heat Recovery Grease Trap Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Pump, Sump Deep Freezer Utility - Water Low -volt, Fire Dishwasher Renew - Temp Service Indirect Wastes Demolition Low -volt, Intercom/Teleph. Repair Circuits Interceptor Dishwasher Roof Inlet Low -volt, Television Water Closet Service, Number of Amps Domestic Well MECHANICAL TYPE Minimum Fee QTY. TYPE QTY. Condensate Drain TYPE QTY. Generator TYPE FY. Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost Bath Tub A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Filter Replace Barbecue Fire Sprinkler System Process/Pressure Piping Sprinkler Repair Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUNIIIIINIG TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. T VPE Miscellaneous Fixture Soakage Pit Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap -Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re-pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink T7TWell, Supply RECEIVED AND REVIEWED BY DATE: ♦ 6 Page 4 • ' PERMIT APPLICATION .... ....... . OFFICE USE ONLY CHECKLIST ❑ OWNER -BUILDER FORM O�PRO ;OF Of OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) (Attach) •. •'. •. . . • •. ❑ FIRE DEPARTMENT 'D:MS / V" APPROVAL ❑ BPR APPROVAL (Restaurants) APPROVAL (Commercial / • • • • • (Sept4c Z Sewer) multi - family) ❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION (New Construction) (New Construction) (On File) ❑ OTHER ❑ OTHER (Specify & Attach) (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) $ Miami Shores Village $ f° Bond $ Metropolitan Dade County (C.C.F.) $ t 6 (sq.ft. = x/1000 x 0.60) Inspector State Educational Fund $ (¢.005 /sq.ft.) State DCA (Radon) $ (¢.01 /sq.ft.) Code Enforcement Fine $ Zoning Review $ Notary $ TOTAL $ D ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: I SECTION I BY I DATE I Electrical Mechanical Fire Public Works Structural Buildin¢ Official Revised July 2001 10050 N.E. 2ND AVE,, MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date �J Job Address es 7 /l, & - 103 5-11 Tax Folio ;;iM -207 a6-05" PB lb Legal Description GOT19 ?-d 7-/7 ��j Historically Designated: Yes �) p No 1/ Owner/Lessee / Tenant 667- Master Permit # 7`D 3 Owner's Address c 5- 2 A/ r � 1 D � i / Phone Contracting Co. ��-a r Address Qualifier State # Architect/Engineer Bonding Company Mortgagor Municipal # SS# - - Phone Competency # Ins. Co. Address Address Address Permit Type (circle one): BUEILDIN/G �ELLECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ll �C�/ ,G /i U5ZZ�i7 6-�& (/4 /W Z6 PIRA 0N/P6—f Square Ft. Estimated Cost (value)�� D� 1 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be perfomied 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. 70 0 ignature of owner or Condo President Date Signature of Contractor er -Boil Date Notary Wo er i4&or Condo President Date Notary o C ntract r or Owner - Builder Date My Commission My C MARY LOU BLOCNER Y :" MARY LOU ROCKER MY COMMISSION # CC 852665 ` MY COMMISSION # CC 852665 EXPIRES: July 6, 2003 EXPIRES: July 6, 2003 ^'r Bonded ihru Western Surety Company 'I�,p bonded Thru Western Surety company FEES: PERI, RADON C.C.F. f NOTARY ""� BOND APPROVED: TOTAL DUE (� Zoning Building Electrical Mechanical Plumbing Structural Engineer vy� MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL. PERMIT p i Permit No..!...�....l.. Date � 8 ......... ... .,�. 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. f} Owner's Name and,Address ......... ...... Qv NL1.!........................ ............ No.......... rl Street... [g:�.(/.,ri.. ... .... Registered Architect and /or Engineer r/ .. Employing Electrician's Namy�'' .�D ..C!( .r� ................................ No.._.. �f3 s!e...,. .......Streee. 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....... Service Overhead Sue Feeders Conduit................ Main Sw............................... Amps .... ..................Main Fuses .............. .......,Amps Underground .................. Type of Installation— Conduit .. ..................Tubing....... ............B.X.L.. ..................Metal Moulding.... .......,............. ................... ........ Amount of Permit $ ...... ......... ................. . ....... (Signed) ....... �i Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under, the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from ail contractors or sub - contractors employed by halm 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) ...... y... Master Electrician. STA'T'E OF FLORIDA, COUNTY OF DADE. 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 die...... .... e ...... ... ... ........» of the above described construction, and he has carefully read the foregoing application, and th4t he did sign the same, and that. ail 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. HEAL SPACE STRIP TOTAL OUTLETS OUTLETS RECE'P'T'S No. LAMPS OUTLET OUTLET .OUTLET CONN. NEATER CONN.. HEATER HEATEIP CONTR. LIST - CHECK ENT. DIST. SERVICE SERVICE MOTORS. MOTORS NEON RADIO TOTAL Sw. CAS. TEMP. PERM. 0.1 HP ,: 1.8 HP TRANS.. CONTR. /) LIST ( - CHECK Service Overhead Sue Feeders Conduit................ Main Sw............................... Amps .... ..................Main Fuses .............. .......,Amps Underground .................. Type of Installation— Conduit .. ..................Tubing....... ............B.X.L.. ..................Metal Moulding.... .......,............. ................... ........ Amount of Permit $ ...... ......... ................. . ....... (Signed) ....... �i Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under, the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from ail contractors or sub - contractors employed by halm 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) ...... y... Master Electrician. STA'T'E OF FLORIDA, COUNTY OF DADE. 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 die...... .... e ...... ... ... ........» of the above described construction, and he has carefully read the foregoing application, and th4t he did sign the same, and that. ail 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. P f MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. Date. .. Z ". .. Application is here m e r the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. his 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 Budding 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 ®® q Owner's Name and Address c' .. 4!'r'Le... .. N,.2-5 .2...X.610 •.y�treet......... Registered Architect and /or Engineer... . Employing Electrician's Name..4�.�9r.... ......_ .........No..9,% t%�..tiei. .t1 1�.............................. Location and Legal Description Lot ....................... ........... ....._.. ..............Block.... ........ ................ Subdivision................................................ Street and Number where work is to be performs No.. �.a . ... . .....................Street . ............................... .. . State work to be performed and purpose of build," ig (By Floors) . .................. ......... ........................... ............................... New Building .... ................ ..Remodeling....... ............ ......Addition.y,.............. '...Repairs.. ......... ..................No. of Stories ......r.. 7.... Service Underground Size Feeders ... ...............Conduit......... Main Svc. Amps Main Fuses .................. .........Amps Type of Installation -- Conduit.. ..Tubing....... ...B.Y.L.. . .................Metal Moulding.... , .......... ................. 111 ....................... ......._. .. - - -- .. ...... .... ...... ... ... .. .......... ......... I ............ .. .. ... ......... ......... ......... ......... ...... ......... ........ Amount of Permit $ ... ... ....... ............... (Signed).......... ......... ......... ....................... Electrical bupector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation as an employer of \,abor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and as complied with the provisions thereof, and will require similar compliance from all contractors or sub•oDrItractors employed by him in the ork 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 \ s are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as , are Yicensed by Miami Shores Village. (Signed) .. ....... ... Ivtaster Electrician. S A, E OF FLORIDA, LINTY OF DADE. 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 fads 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. it r SWITCH UaNT PLUS REFRIO. IRON RANGE RANGE. WATER W. HEAT. SPACE STRIP TOTAL CUTLETS OUTLETS RECE•P'T'S IFIXfuR rv0. LA OUTLET OUTLET OUTLET , CONN. HEATER CONN. HEATER HEATER LIST CLIST � � CHECK ► , ENT. DIST. SERVICE `.SERVICE MOTORS MOTORS NEON � RADIO TOTAL SW. CAS. TEMP. - :PERM. O.t HP 1.9 HP TRANS. CONTR. �- ' LIST Service Underground Size Feeders ... ...............Conduit......... Main Svc. Amps Main Fuses .................. .........Amps Type of Installation -- Conduit.. ..Tubing....... ...B.Y.L.. . .................Metal Moulding.... , .......... ................. 111 ....................... ......._. .. - - -- .. ...... .... ...... ... ... .. .......... ......... I ............ .. .. ... ......... ......... ......... ......... ...... ......... ........ Amount of Permit $ ... ... ....... ............... (Signed).......... ......... ......... ....................... Electrical bupector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation as an employer of \,abor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and as complied with the provisions thereof, and will require similar compliance from all contractors or sub•oDrItractors employed by him in the ork 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 \ s are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as , are Yicensed by Miami Shores Village. (Signed) .. ....... ... Ivtaster Electrician. S A, E OF FLORIDA, LINTY OF DADE. 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 fads 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. it r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ` Job Address a-S% IV 03 �sr L Tax Legal Description �07 V 12 Owner / Lessee / Folio 13 Qzi2Q i O' io Master Permit # ®� Owner's Address old / -lyt- l 0 S `--Y - Phone Contracting Co. b /v 0 � Address / VOW S Qualifiers SS #_� - Phone 5` ipsd� State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION r / Square Ft 3C) Estimated Cost(value) J WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authori the above-named �c contractor to do the work stated Signature of own r and /or Condo President Signature j°f Cont ctor or Owner- Builder Date: Date: /f(,( r s Notary as to Owner and /or Condo President Notary as to �Cto g i"311 ; i r My Commission Expires: My Commission ires§ � scow VJ DAVIS COMMISSION NUMBER CC255237 GOPAWSSION EXP. FEES: PERMIT �%� ►OD RADON C.C.F. NOTARY TOTAL DUE .W0 APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbi Engineering �y WE STATE OF FLORIDA DEPARTMENT OF HEALTH SAND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTIJQN PERMIT Permit Application Number --------------------------------------- ------------------------- - - - - -- -PART II - SITE PLAN----------------------------------------------------------------- - - - - -- Cr,n1a- Fach hlnrrk renracPntS 5 feet and 1 inch = 50 feet. Notes: Site Plan submitted by: -� GNATURE Plan Approved By Not Approved Date = f County Public Unit ALL CHANGES MUST BE APPRI t HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002. 4015-6) D BY THE COUNTY PUBLIC HEALTH UNIT Page 2 of 3 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date `� �l Job Address �`� �d S ! Tax Folio Legal Description Owner / Lessee /Tenant LO (3' t hjLyC i Master Permit #�7� Owner's Address _ i . / Phone,-/ S %° ?J�3 Contracting Co. _6 WAI& -P_ Address Qualifier SS# - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company. Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL` PLUMBING `MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION. 6�� i C 0C,/-1(__ l _JA 1 xf, 0K_ 1-76e Square Ft. Estimated Cost(value) 56 O WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done.in, compliance with all applicable laws regulating construction and zoning. Furthermore, I auth�?Fji Lx.,tle above -named contractor to do the work stated. Signature of ownerG nd /or Condo President Signature of Contractor or Owner - Builder Date:_ Date: Notary ,ds to Owner and/ CIAL NOrp TAdRY S .A My Commission Expires: Y_ LOU NOTARY PUBLIC STATE OF FLORIDA MARY LOU BLOCKM COMMISSION NO. CC472323 Notary as to Contractor or Owner - Builder My Commission Expires: itit * * * MY CO LSSIOIri EXP. UXE 14,1999 * * * * * * * ** ITO FEES: PERMIT _�) 5_• RADON C.C.F. NOTARY TOTAL DUE 3` APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE I Date � Job Address x` o�� Q S f Tax Folio - Legal Description Historically Designated: Yes No Owner/Lessm/ Tenant ,r 2E 12—O N C UA J� i �0 % Master Permit # Owners Address __a 51 UE 10 .3 STR FF.71 Phan Contracting Co. CI.eWel- Address Qualifier SS# - - Phone State # Municipal # Competency # Archited/Engmeer Address Bonding Company Address Ins. Co. Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION X ��l�i MOS06 Square Ft Estimated Cost (value) X � � WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING; CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner an&J Condo President ate Signature of Contractor or Owner- Builder Date - A "4 4//Y, /. ?, - Notary as to er and/or Condo President Date Notary as to Contractor or Owner - Builder My Commission Expires: N p'wo My Commission Expires: OFFI 1A I SEAL CL�DYv Ii'' RcO NOTARY PUBLIC q n A 01; FLORIDA COMMISSION NO. CC170"V MY coMMISSiON Eyp, MAR. 1,1996 J FEES: PERMIT 37, g RADON C.C.F. S NOTARY APPROVED: Zoning Binding Electrical Mechanical Plumbing Engineering_ Date TOTAL DUE g r a �$, ao rj' 3 , a c� STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DI- SPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC PERMIT # DATE PAID .' FEE PAID RECEIPT # CONSTRUCTION PERMIT FOR: [ ] New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental [J Repair [ ] Abandonment [ ] Other(Specify) APPLICANT: ! - 7 AGENT: PROPERTY STREET ADDRESS: LOT: BLOCK: SUBDIVISION: -- PROPERTY ID #: ` ,�`' [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] �J SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. SYSTEM DESIGN AND SPECIFICATIONS T [ ] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ J D R A I N F I E L D 0 T H E R SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ ] SQUARE FEET SYSTEM TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND CONFIGURATION: [ ] TRENCH [ ] BED [ ] LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE [ BOTTOM OF DRAINFIELD TO BE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ ] INCHES SPECIFICATIONS BY: TITLE: s^ APPROVED BY: TITLE: DATE ISSUED: / 0 HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001-4016 -0) APPLICANT CPHU EXPIRATION DATE:. i Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number assigned by CPHU. APPLICATION FOR: Check type of permit, if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT : Pr v�.i;� owner's le dal J autborized repesentative, MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY IDk: 27 character id number for property. (CPHU may require property appraiser ID H or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter IOD -6, FAC. DRAINFIELD: Minimum specifications from Chapter IOD -6, FAC. OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date Issued. MIAMI SHORES VILLAGE PLUMBING 'WSPECTiON DEPARTMENT -� G ':._ APPLICATION FOR PLUMBING PERMIT Permit No. -1 -� Date --- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and.conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all - ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ----- - - - --- = - - -- - ------------ - - - - -- No - - - -- Street-----.- Registered Architect and /or Engineer. - T --------------------------- ploying Plumber's Name- -- - _f_L_i`� - -_ �� �::__ __.� *�__.!,Ato.- _---- - - = - -L Street - - - -- - -�- x - - Employing Legal Description Lot__ -_- u__ --- __ -_ - 7r-_1 Block--------- _ - - - - ------ _ - - -- Subdivision - _____- °_ -- --- Stret and Number where work is to be performed— No. - - -- --- - - - - -- --- - - - --- --- - - - -- _ ___ - - - -- - -_.__ Street - - -- _ - - - - -- ----- - - - - -- - - - - - -- — ------------------ ` Statework to be performec).and purpose of building (By Floors) -- - - - - ---------- --------- ----- - ----------------- - ------------------------------ - -------- - --------- .- ------- -___---__-_-- Cam' New luilding------------------------------------ Remodeling - - - -- _ - - - --------------- - -- Addition _ - - - - - -- - - - -___ =- Repairs -------------------------- No. of Stories - -___ ___. - -_ _ _ _Size ePtic 1!k-- - - - - -- LG2_0_0 ------------ - - - - - -- -Type of Tank- - - - - - -- Capacity Gals. - - - - - -- - - - - - -- Feet of Drainl e___ -- _ ---- -1- U - -�- ------ Dist. Feet of Tank or Drain Field from Well- ----------------- - -- Nature, of Wati'Supply: City—Well ----- - --------------------- - - --------------- -------------- Size of Soakage Pit ----------------------------------------------------------- - - - - -- - - -- - - -- -- -- Amount of Perm) $ ° -`% °�} - - - - -- --- - - - - -- ( Signed) -- - - - - --- -------------------------------- - ------ - - -- - - - - -- - — Plumbing Inspector. The undersigns applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida 4orkmen's Compensation Act, being Section 5966, Compiled General Laws of "Florida Permanent Supplement, and has com- Plied with the provi,ons thereof, and will require similar compliance from all contractors or sub- contractors employed by him -in. the work to be performed under tlu"rxnit; 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 ActThe undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Slices Village. ( Signed) - - - -------------------------------------------- --- - - - - -- - - - -- ---------------- Master Plumber.. STATE OF FLORIDA,'; COUN'T'Y OF DADE. � �' Before me, the underigned 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 de oses 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 Eipires otary 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.° r BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL .CLOSETS TUBS SHOWERS TORIES SINKS SINKS`. TUBS URINALS gA31N DRAIN FOUNT'NS FIXTURES LIST . - -- - .: CHECK -- iPTIC .SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR• SWIM'G- NK CONN. FIELD '.PIT TRAP HEATER. WELL SYSTEM POOL. CONTR. .. LIST ' ..CHECK _.. _ _Size ePtic 1!k-- - - - - -- LG2_0_0 ------------ - - - - - -- -Type of Tank- - - - - - -- Capacity Gals. - - - - - -- - - - - - -- Feet of Drainl e___ -- _ ---- -1- U - -�- ------ Dist. Feet of Tank or Drain Field from Well- ----------------- - -- Nature, of Wati'Supply: City—Well ----- - --------------------- - - --------------- -------------- Size of Soakage Pit ----------------------------------------------------------- - - - - -- - - -- - - -- -- -- Amount of Perm) $ ° -`% °�} - - - - -- --- - - - - -- ( Signed) -- - - - - --- -------------------------------- - ------ - - -- - - - - -- - — Plumbing Inspector. The undersigns applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida 4orkmen's Compensation Act, being Section 5966, Compiled General Laws of "Florida Permanent Supplement, and has com- Plied with the provi,ons thereof, and will require similar compliance from all contractors or sub- contractors employed by him -in. the work to be performed under tlu"rxnit; 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 ActThe undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Slices Village. ( Signed) - - - -------------------------------------------- --- - - - - -- - - - -- ---------------- Master Plumber.. STATE OF FLORIDA,'; COUN'T'Y OF DADE. � �' Before me, the underigned 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 de oses 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 Eipires otary 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.° r ADDRESS 257 TJ -E. 1032-d St. _LEGAL _n.:, li9s raic. 1_z. , li s 5;, 5REGO_R, D GARBAGE TALC ` -- -' - -'- 3/18`749 - -'- RECEIPT �_,], .occ. -- RAID BY - - "`.. _ __- -. -. -.,. - -_`. -YEAR - -- - ANNUAL TAX-- PEii1iDDtTSED -` == AMOkiiVT P &tD °- ..DACE P F-D - - ='= -NUMBER ��a1 1 �cD o �1d. o S • / �= 5� 1� �! ` %12.00 12- 31 -2,9 8.00 Y -6 —L 9, 13 263 . H i -U .� ��!'`�U � 3.0G► �"'� -'gip 'JSbO t� BUILDING PHONE INSPECTIONS INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION -J $ SEPTIC TANK BEAMS :& LINTELS $ SOLAR HEATER FRAMING = Y� $ INSPECTIONS DATE BY RE- INSPECT FINAL RE- INSPECT BY ROUGHING CLEAN -UP GAS o ' PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK $ _ - SEWER $ SOLAR HEATER - $ GAS $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING GAS o - SEWER SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL PERMITS & • INSPECTIONS CONTRACTOR 1 Q - PHONE PERMIT NO. DATE � FEE $ = UELK-BLDG _ _ __ ==ALTERATION 15 --- ADDITION , . — -- -LKePA KS_ - __ _,_ _ SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ _ H. W. HEATER CONN. $ RANGE CONN. $ FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING o - H. W. HEATER CON RANG CONN. FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY x OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHON�%NO. R.�. lbDonald ( I Ij I JOB LOCATION (ST.ORAVE.) LOT BLOCK 'II'i SUBDIVISION 2,57 D1,' z 10 d 9t. � �- I � � � t� � r , 'GENERAL CONTRACTOR I ADDRESS li PHONE NO. LICENSE NO. BUILDER'S BOND A�jI/D� BUILDING PERMIT NO GM IDATE—lafi=u I - PERMIT F.EE_ 000 - I O. DATE I � •tia ZONE REQUIREMENTS CU. FT. PLAN CU _„ . . _ CU, -FT. ST.. C 1 000 DATE i DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE I STORIES I ROOF CONSTRUCTION I INTERIOR CONSTRUCTION NEW CONSTRUCTION I DSSCR IPTION REPAIRS re= Ili 1por —e . ""A ALTERATION DESCR,PTION ADDITION APPROVED REJECTED REFERRED TO COUNCILI REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOAR I I REMARKS gUBMITTED TO VILLAGE COUNCIL CERTIFICATE 'e Z- OF OCCUPANCY NO. lAF' ISSUED BYA� rsu LLuimu t'GiiMIT AND 1145PECTI0N RECORD-MIAMI SHORES VlI+LAGE BUILDING INSPECTIONS - INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION $ - SEPTICTANK - SEWER BEAMS & LINTELS $ SOLAR HEATER $ FRAMI G $ $ INSPECTIONS DATE BY RE- INSPECT BY RE= INSPECT FINAL ROUGHING CLEAN -UP GAS PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE 'PERMIT NO. DATE FEE $ NEW BLDG. ALTERATION ADDITION REPAIRS �PECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ - SEPTICTANK - SEWER $ SOLAR HEATER $ GAS $ $ INSPECTIONS DATE BY RE- INSPECT BY RE= INSPECT BY ROUGHING GAS SEWER SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL. PERMITS & INSPECTIONS CONTRACTOR ,•.;"_ PHONE PERMIT NO. DATE FEE $ �- -=UEW -BLDG. - - - -- ---[-ALTERATION . - _ ADDLTION_-_ REPAIRS _ - - SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUG NG - - - H. W. HEATER CONN RANGE ONN. FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY OWNER'$ NAME PRESENT ADDRESS LICENSE NO. PHONE NO. PAUL a. mamium 257 N. T. 103 Street I JOB LOCATION (ST. � AVE.) LOT BLOCK SUBDIVISION 257 N. E. 103' Street '' I I w GENERAL CONTRACTOR ADDRESS I PHONE NO. LICENSE NO. -... BUI DER'S BOND BUILDING PERMIT NO. 32335 )) DATE 4- 1 PERMIT FEE 5-00 NO. DATE 'z 3 ` -r`96 y-,7- / - 250000 ,7! ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COST S DATE im 14-18-51 DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE STORIES ROOF CONSTRU ION INTERIOR CONSTRUCTION NEW CONSTRUCTION I I f DESCRIPTION IREPAIRS ALTERATION A� �1 DESCRIPTION Sake ad Porch Addit ion _ ADDITION APPROVED REJECTED REFERRED TO COUNCIL REASONS SUBMITTED TOP ANNING,BO RD I RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUIJCIL ®/ CERTIFICATE OF OCCUPANCY NO. / ° / ISSUED " BY '- TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAw` BUILDING INSPECTIONS INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 1� JDH B MS & LINTELS 'FOAMING 2 2 Tn7� sriH jig FINAL 13/18/49 �CLEAN-UP Harold PERMITS & INSPECTIONS - CONTRACTOR Harold. hoods - - - __- _._... PHONE - - - PERMIT NO.. D DATE' F FEE $ 2 - 'ALTERATfcrN-- _ =ADDITION ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR Ho & Ho Zleatric PHONE PERMIT NO. 7625 1 DATE 91=9 FEE .$ 6 NEW BLDG. _. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE _ $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING 2/2?M ME H. W. HEATER CONN RANGE CONN. FIXTURES R FINAL APPROVAL TO POWER CO. FOR SERVICE DATE 3/18/49 By JDH `3 APPROVAL TO POWER CO. FOR SERVICE DATE 3/18/49 By JDH `3 A OWNER'S NAM �, t) PRESENT ADDRESS TO W! . P14ONE NO. D. J. CRANE j �''� � 120' N. 11. 98th St. ( JOB LOCATION (ST. 0 AVE.) LOT BLOCK SUBDIVISION N. E. 103rd Streit I 1g 10 19 ( 119 ) ldvz3 Shares Wit. 5'' h _9.57 GENERAL CONTRA :TOR ADDRESS PHONE NO. LICENSE NO. D. J. Crane I I UILDER'S BONlO ' Q I 14.0 d BUILDING PERMIT NO. DATE PERMIT FEE NO. DATE 6� if Q ZONE REQUIREMENTS 2500 CU. FT. PLAN CUBE 15.699 CU FT -) 'EST COS'TI' S: ,I DATE DRAWINGS, SPECIFICATIONS, REST ICTIONS AND CUBE CHECKED BY: JDH 1 I 1 ?/211_ I TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION NEW CONSTRUCTION !, C I Tile I Plaster DESCRIPTION REPAIRS I �+�W. I` q� II L�,n Kit., Eno Prep Bedrms Both '� DESCRIPTION ALTERATION 'll P att8ched garage ADDITION �1 APPROVED REFERRED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD 12/21/4E �J Bli by RE- SUBMITTED TO PLANNING BOARI I I i i! REMARKS SUBMITTED TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. 13 ISSUED 3/18/:.9 BY TM I TO D. ' J. Cr»e. 2V NE l( ,4-m q+ BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE r7} __'s 4--c-7 z --q-C 'c �UILDING PHONE PERMIT NO. �S d S L DATE S- t> - "s, w •- -7 , - ,of j INSPECTIONS DATE BY RE- INSPECT BY REINSPECT BY FOUNDATION $ SEPTIC TANK _ $ BEAMS & LINTELS - . 57 $ SOLAR HEATER FRAMING O.%.. $- -� �fl'_ia $ ' 11�.- l�j INSPECTIONS DATE BY RE- INSPECT BY FINAL BY ROUGHING z7- @- 4 6✓C4J CLEAN -UP GAS PLUMBING PERMITS & INSPECTIONS CONTRACTOR 16. 1 - cl a +i PHONE PERMIT NO. �S d S L DATE S- t> - FEE $ �57 € c, NEW BLDG. I ALTERATION ADDITION R PAIRS SPECIAL PERMITS PERMIT NO. DATE FEE - TEMPORARY SERVICE $ SEPTIC TANK _ $ SEWER $ SOLAR HEATER $ GAS $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING z7- @- 4 6✓C4J R' �f. GAS SEWER _- SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR _ '600_jl J� r, EW. PHONE PERMIT NO. Z 6 DATE S 18', FEE $ NEW BLDG. ALTERATION I ADDITION LREPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE - $ -- H. W. HEATER CONN. $ RANGE CONN. $ MOTORS _ FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE BY E d s f OWNeR'S DAME P ESENT ADDRESS— LICENSE NO. t 1PHONE NO. M& IRS VILEIAN KOFOEO 257 1 E 0 �.�87 e J JOB LOCATION (ST. OR AVE.) LOT BLOCK SUBDIVI ION 257 N.E. 103rd Street 119 & E -- 20 I 119 I Miami Shores Section % 5 GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO. Owner Day labor or I 257 N.E. 103rd Street BUILDER'S BOND 5423" I 5.1"57 I BUILDING PERMIT NO. DATE PERMIT FEE S °�.00 NO. 2124 DATE 5-1 -57 ADDITION 645 I 180 EQU ZONE REQUIREMENTS CU. FT. FLAN CUBE CU. FT. EST. COST $ DATE DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C. H. MAREEL 5-1 -7I TYPE I STORIES ROOF CONSTRUCTION I I INTERIOR CONSTRUCTION NEW CONSTRUCTION DESCRIPTION REPAIRS ��ppeEt�t ADDITION BATH ADDITION O a1,a;x7 DESCRIPTION ALTERATION ADDITION APPROVED REJECTED REFERRED TO COUNCIL REASONS SUBMITTED TO PLANNING BOARD I I I RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUNCIL I CERTIFICATE OF OCCUPANCY NO. ISSUED BY a TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE BUILDING El ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner 4 Buildinc Architec Contras or Build Legal Descripi Address Buildinc } DATE_ .- 195 PERMIT ? 14745 Contractor's License No._ Work to be performed under this Df A for er Lot II Bl, Subdi- :ion, vision o{ Value of Amt. of s._„ �,• Project $ Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he ssumes respoasibili y for work done by his agents, servants or employees. Signed _ —�� 4'� � r BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING D'° ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner Buildinc Archite, - ontrac or Builc Legal Descrip Address Buildinc MIAMI SHDRES VILLAGE, FL13PIDA DATE': 195 PERMIT N? 1472Q., retract 10 N h: Work to be performed under this hermit_ — of !tor ler Lot II Bl, Subdi- tion vision 3 of Value of Amt. of Project $ Permit $ „. This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed:_ ___ —_ BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUMDING ❑ DATE 195 ELECTRICAL ❑ PERMIT W? 11335 Contractors PLUMBING ❑ License No ROOFING ❑ Work to be performed under this Permit Owner Buildin Archite - ontrac or Build Legal Descrip Address Building of g ct for er Lot II Bl, Subdi- tion vision of Value of Amt. of Project $ I Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ �T i ♦ DATE 195 ELECTRICAL. ❑ PERMIT ',i� ? 1141.1 Contractor's PLUMBING ❑ License No ROOFING ❑ Work to be performed under this Permi Owner of Building_ Architect - ontractor or Builder Legal Lot II 131. Subdi- Description. vision Address of Value of Amt. of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL PLUMBING ❑ F-] PERMIT ROOFING ❑ Owner of Building Architect Contractor or Builder N? 3625 Work to be performed under this DATE 195 - Contractor's License No. Legal Lot II I Subdi- Description — Bl. vision - -_ Address of r Value of " ' Amount of Building Project ++ Permit $ �.w. 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 applicati herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any pia: drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at a: 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 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulatio pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for we 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 regulatio pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In < cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. , CONTRACTOR OR BUILDER f }Y AUTHORITY e BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ MIAMI SHORES VILLAGE, FLORIDA PERMIT N04 4779 Work to be performed under this Owner of Building i Architect Contractor or Builder :�`;.. �.. Legal Lot Description ' I Bl. Address of Building Subdi- vision DATE 195 Contractor's License No. Value of ! Amount of Project $ j) Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time If the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY sue- MIAMI SHORES VILLAGE. FLORIDA {° WILDING ❑ ;LECTRICAL ❑ DATE 195 X ILUMBING PERMIT N° 6656 Contractor's -21 ' g- e'GOFING ❑ License No. ❑ Work to be performed under this Permit — )wner of luilding architect , ontractor, r Builder' egal Lot II of f` Bl. f Subdi- vision — Value of Amount of Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work by his agents, servants or employees. Sinned:- 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 ling thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- 1 this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTCR OR BUILDER BY AUTHORITY BUILDING [� ELECTRICAL ❑ PLUMBING ❑ ROOFING MIAMI SHORES VILLAGE. FLORIDA PERMIT N° 5471 DATE 195 Contractor's License No. — ❑ Work to be performed under this Permit -- Owner of Building Architect _ — Contractor or Builder Legal Lot I Subdi- Description II Bl. — — vision Address of Value of ' Amount of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A furthor condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. ,� Signed: "BY: °— — INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 6 MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ DATE -` ; 195 PLUMBING ❑ PERM 1 T N? 5 4'7 0 Contractors � F. License No. -_ -. ROOFING ❑ ❑ Work to be performed under this Permit Owner of .. ,. Building -- Architect Contractor or Builder Legal Lot Subdi- Description — Bl. -- — vision Address of + Value of Amount of Building ~', Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper. municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A furthcr 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: t et — - BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered Ynder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications sub itted 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 n AUTHORITY BUILDING ❑ ELECTRICAL ❑ PLUMBING 1 ROOFING ❑ MIAMI SHORES VILLAGE. FLORIDA DATE f 195 PERMIT N? 5456 Contractor's License No. f' Owner of Building Architect _ Contractor or Builder Legal Work to be performed under this Permit Lot.,' of 44 Bl. % 4J f� Subdi- -. vision }f'% Value of Proiect Amount of 3 - 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 or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work by his agents, servants or employees. Signed: - t... BY: - INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered, hereunder in compliance with all ordinances and regulations ining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- ng this permit I assume responsibility for all work done by either, mp ¢gent, servant or employee. CONTRACTOR OR BUILDER BY W AUTHORITY MIAMI SHORES VILLAGE. FLORIDA 13° e, z BUILDING ' DATE �'� "�" �" 195 ELECTRICAL F1 PERMIT N° 5 r A� PLUMBING ❑ , ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect - (- Contractor or Builder L ' Legal Lot Subdi- r� Description ! Bl. l I — vision Address of -'•_ Value of Amount of Building _ Project `' ' Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 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 M* THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE A PEVLTY IS IMPOSED FOR FAILURE TO KEEP THIS LICENSE EXHIBITED AT YOUR ESTABLISHMENT OR PLA E.OF .BUSINESS Village THIS LICENSE EXPIRES In consideration of the sum of 4 s71t7oI93a ier ■terM acense �'tORiDp` 19 -__._ D i I, Paid to Miami Shores Village, Dade County, State of Florida, is hereby licensed to engage in or operate the business of N? 188'7 lars �$ - -- - - -- -- MIAMI SHORES VILLAGE, FLORIDA Date Issued = - -- - -- BY —= . THIS LICENSE NOT'TRANSFERABLE WITHOUT THE--APPROVAL OF THE VILLAGE MANAGER. MBY ��9R6 APC 6.�O MIAMI SHUPIES VILLAGE, FLORIDA BUILDING DATE --L �- 194 ELECTRZICAL PERMIT N° 7583 Contractor's PLU BIND License No. Work to be performed under this Permit_ /� _i.•�"' '' Owner of r� Building Architect Contractor or Builder .._aA,_��*/�f Legal Lot II Bl. Description Address of t Subdi- vision Value of �� Amt. of�5� -� ��•-� 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 appli- cation 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:g=,.% INSPECTOR In consideration of the issuance to me of this permit I agree to perform, the work covered hereunder in compliance with all ordinan and"yregulfttions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ting this pennssume responsibility for all work done by either myself, my agent, servant or employee. f ' Y 1 CONTRACTOR OR -BUILDER BY AUTHORITY BUILDING ELECTWAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA�f DATE L Z 194 PERMIT N° 7622 Contractor's License No._ Work to be performed under this Permit Owner of Building C �" Architect Contractor or Builder 4 Legal Description Address of Lot `II Bl. 0 Subdi- vision Value of Amt. �, Permi ° ' 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- cation 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 drawin s or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. i Signed: 'L_F44 "a - INSPECTOR In consideration of the issuance to me of this permit I agree to perforrn'th�ork covered hereunder in compliance with all ordin nc and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of i Shores Village. In accepting this pnit I assume fesponsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE -- 1 194 ELECTRICAL PERMIT N° 7625 Contractor's PLUMBIiJG j License No. Work to be performed under this Permit�_�.- �-✓�"' t/.�..�� -^'' Owner of Building Y Architect Contractor or Builder "�✓ `e Legal- Lot I Bl. Description Address of Buildinv Subdi- vision Value of 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- cation 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 4e assumes respon- sibility 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 perfo t, e work covered hereunder in compliance with all ordi s 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. Iny CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA c,� BUILDING DATE - 194_2. ELECTRICAi, PERMIT N? 7459 Contractor's PLUMBING License No. Work to be performed under this Permit Owner of Building - •. `r.• fiQ�fr; � Architect Contractor or Builder`' -U' Legal Lot �/ / // (I Bl Description X .✓ U� /'.Z �] Address of -• .1 Subdi- vision Value of II Amt. of Yj Project -� l� �' � Permit // __0 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- cation 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 incompliance 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. j Signed: r' " _ + 4•-+- By _ SPECTOR In consideration of the issuance to me of this permit I agree to perform t e, work covered hereunder in compliance with all ordinan and regulations pertainin o din strict fortuity with the plans, drawings, statements or specifications submitted to the proper authorities of IVliamihos Village. In acce in th' e it I ass a ` esponsibility for all work done by either myself, my agent, servant or employee. NTRACTOR OR BUILDER BY AUTHORITY BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING i ❑ MIAMI SHORES VILLAGE, FLORIDA Date PERMIT N° 8299 Work to be performed under this Permit Owner of Building 4, c Architect Contractor Contractor's License No. -— or Builder - - - -- Legal Lot �, Subdi- Description /3 II Bl. i tom_ vision ----- - - - - -- Sq. Ft. Address of ,�- "' �— Value of Amount of Building f "� 1 ` Project $r 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 an }- 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) BY— 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 1. Ir i BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ - ❑ Owner of Building Architect MIAMI SHORES VILLAGE, FLORIDA Date -- - -- -- 19—/ PERMIT N 8848 Contractor's License No. Work to be performed under this Permit Contractor or Builder — — — - -- Legal Lot Subdi- Description 131. vision — — — Sq. Ft. 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) BY--. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER BY AUTHORITY BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA Date — ELECTRICAL ❑ QQ Q a PLUMBING Q 8838 PERMIT N? Contractor's License No. ROOFING ❑ Work to be performed under this Permit - -_ Owner of Building. —_ Architect Contractor or Builder r Legal Lot I II Subdi t Description BL vision -- — — — Sq. Ft. Address of Value of Amount of Building �` t _ 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) BY -- In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself,,my agent, servant or employee. CONTRACTOR or BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING ,f r_1 d i. _ . ,.. _. ml MIAMI SHORES VILLAGE, FLORIDA �j Q p Date. -- PERMIT N? 8803 Contractor's License No. Owner of Building Architect . Contractor Work to be performed under this Perm If t ;:- or Builder Legal Lot Subdi- Description I Bl. vision — Sq. Ft. Address of Value of Amount of Y'~? 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. r' r j Signed._ (INSPECTOR) BY —__ In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER BY AUTHORITY BUILDING ❑ ELECTRICAL PLUMBING ❑ ROOFING ❑ ❑ Owner of Building Architect Contractor or Builder t MIAMI SHORES VILLAGE, FLORIDA Date—. �. - -- 19, PERMIT N° 9018 Work to be performed under this Per Legal Lot Subdi- Contractor's License No. Description I I Bl. vision -- Sq. Ft. - 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) BY —_ 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 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 2 �� A If 1 � 3j—'2 Tax Folio ( N Legal Description Lo t ou, 4- 6 �� % q U 119 lY1,l, S�Hi torically Designated: Yes No Owner/Lessee / Tenant Z .66�T- aoT Master Permit # Owner's Address ,� � % Al. 16. / 6 3 57"? Phone :2 -5- Z2::,-2 _ ? —% Contracting Co. 6WIV "'-& - Address Qualifier State # Architect/Engineer Bonding Company Mortgagor Municipal # SS# - _ Competency # Address Address Address Phone Ins. Co. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION l� L��,L AC� L K C51_1W 6— 00bleA49YJ �tJ%U D Square Ft. cPZ DO Estimated Cost (value) 3 0 U y d WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owne and/or Condo President Date /V�' �"/ //'�' " 7 Notary s to wne and/or Condo President Date My Commission Expires: ' y Lou P. MARY LOU BLOCKER I NOTARY PUBLIC STATE OF FLORMAJ COMMISSION NO. CC472323 My COMMN7610, FY.P. TUP'T, ?e ,ar3Q . FEES: PERMIT RADON APPROVED: Zoning Signature of Contractor or Owner- Builder Date Notary as to Contractor or Owner- Builder Date My Commission Expires: C.C.F. NOTARY Building Electrical Mechanical Plumbing Engineering • • JQTAL DUE... CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N? '711 Miami Shores Village, Fla. Owner, Agent or Tenant of Building Lot Block— Subdivision Street Address Approved use by occupancy Remarks: This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 02 3 6 G Job Address /D-3 S'�' Tax Folio i " � J� a 13 -0 7 0 Z Legal Description ,4- D T 1 k 4- W `�4 (0 7-2? XL K 11 Historically Designated: Yes No__2L Owner/Lessee / Tenant C D 96e-r /e 6,6 a' j &22 _ Master Permit # C1 Owner's Address c2 5'- ?IV. L . 16 3 Phone 6 5-- 2.:2- 7 S Contracting Co. P,4 119? ,�% /C ; ZAZ(, Address !'t10 / 0 I V, U/ j 5- 3 3'( 4C. Qualifier V6 6 EKI- /C fJ� do-774 SS# Phone :40 State # C4 C-636 9-S3 Municipal # Competency # Ins. Co. U/q-c TV W. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit T pe (circle one): BUILDING ELECTRICAL PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN C i O U-r- WORK DESCRIPTION 9E P64C E 66 EZZ 6f4Z 'T FL 4h, N17-5 3'1 ,/0 W/)oKit/ Square Ft. Estimated Cost (value) 0 5 00 '— WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a penult to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date Signature of Contractor or & er- Builder Date /4y/, /ci,/ --- W,/, '/", ZiA d � Notary y6 to Date Notary as1fo eontractor or Owner - Builder Date My Commis s des: MARY I..OIi BLOCKER My Commissio MY COMM'SSION # CC 852665 ""110"•�•r... N EXPIRES: July 6, 2003 *? ' MARY LOU BLOCKER Q �- �F My COMMISSION # CC 852665 a4„ t3ondad Thru Weslem Surety Company -'?.. a EXPIRES: O MR 1 �J a " Bonded Y 6, 2003 Thru Western Surety Company FEES: PERMIT RADON C.C.F. NOTARY BOND APPROVED: TOTAL DUE Zoning Building — Mechanical rlurnbin6 Electrical Structural Engineer Type: Permi Name 3(,0),5- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Address S I / _ � '. F - / 0 Company Phone # For Inspector Approved Correction ❑ Re- Insp'n Fee ❑ Name & Date MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.---7) ____ Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address je, - =f°_ _} — No. f Stree : �I�- I- �`-- - - -� -� / Registered Architect and /or Engineer---------------------------- -------- ---------------- - - - - -- --------------------------------- --- ------------------------------ ------------ — ---------- * ---- -- -- - -- --- Employing Plumber's Name____ -- Location and Legal Description Street and Number where work is to be performed —N Street---------------------------------- ------ - - - - -- State work to be performed and purpose of building (By Floors) ------------------------------------------------------------------------------------------------------------------------- New Building ------------------------------------ Remodeling -------------------------------- Addition--- ----- ---- ----- -- - - -- Repairs -------------------------- No. of Stories— ------------ Size Septic T Feet of Drain Nature of Water Z S Amount of Permit $ __________'_t______- __________. ofTank----------------------------------------------------------- - - - - -- Capacity Feet of Tank or Drain Field from W of Soakage (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, o work to be performed under this permit, as are licensed by Miami Shores Village. t, (Signed) -------- - - - - -- — - -- ` Ma ter Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ---------------------------------------------------------------------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES EONTR 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 T Feet of Drain Nature of Water Z S Amount of Permit $ __________'_t______- __________. ofTank----------------------------------------------------------- - - - - -- Capacity Feet of Tank or Drain Field from W of Soakage (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, o work to be performed under this permit, as are licensed by Miami Shores Village. t, (Signed) -------- - - - - -- — - -- ` Ma ter Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ---------------------------------------------------------------------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE i BUILDING DEPARTMENT 305 -735 -2204 Building Inspection Request Date' Z YO 3 Time i Type Insp'n Permit No. 7 ' t 3 I/ L` Name Addressr�~1 Company Phone # For Inspector Name & Date Approved Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No - - -- _ C ----------------- - - - - -- Date ------ Z_- -- 2''=' -~ -14 7---------- - - - - -- 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 - -__)9 _, (� I - �=----------- --- -- •--------- ------ No. - -� �} - 1---------------------------- Street -- � - -J--- A-- Registered Architect and /or En - neei'----------------------------------------------------------------------------------------------------------- - - - - -- - g 87 Employing Electrician's Name --- l- � i �_ ti_____ ___________Street___: _Sc _ !_ -(+ - - - - - -- __- -- =__ LI_! �I Location and Legal Description Lot_1_1 --- r-IN/�__- __!__- ------------------- .------ Block ------ )_ LI ---------------------------- Subdivision___�_'_.2�____,�+�1 __v! Street and Number where work is to be performed— No.___'_ 1..,_ 6_ 7______._._______________________________ ____________ Street___t4 __r._ --- LO 3___ S __t__a____________________ -____ State work to be performed and purpose of building (By Floors) -------------------- - ___ —____ ______________________ ------------------------------- ------ - __- ----------- New Building -74- - - - -- -------- - - - - -- Remodeling----------------- ------ - - - - -- Addition...------------------------ - - - - -- Repairs_------------------------------ - - -No. of Stories-------- -- ---- - -- - -- 1. tOverhe _ ' 1 Service Un erground Size Feeders-4-1 --------- Conduit --------- A- --- Main Sw___ -------------------------- Amps --------------------------- Main Fuses -------------------------- Amps Type of Installation- Conduit------- - - - - -- -- -- u m - ----------------- B.X.L ------ --'- -- - - -- -Metal Moulding------------------------------------------------------------------- ----------- -- - -- -- �y Amountof Permit $ - - - - -- x= 4 ----------------------------------------------------- - - -- -- (Signed) - - - -- -� -- - ----------------------- - � txicalInspector---------- The undersigned applicant for this building permit does hereby certify tha , e understands and accepts his ob ions 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 frorn 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. IF (Signed) -- - ----- -- - - - -- - -- -- - - - - - -- - -- - -' -------------------- - ------------ Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. 1T ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the --------------------- _--- ..---------------------------------------------- of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My 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 CONTR. � ( f LIST l ice.. �` T — CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0-1 HP 1.5 HP TRANS. CONTR. LIST CHECK 1. tOverhe _ ' 1 Service Un erground Size Feeders-4-1 --------- Conduit --------- A- --- Main Sw___ -------------------------- Amps --------------------------- Main Fuses -------------------------- Amps Type of Installation- Conduit------- - - - - -- -- -- u m - ----------------- B.X.L ------ --'- -- - - -- -Metal Moulding------------------------------------------------------------------- ----------- -- - -- -- �y Amountof Permit $ - - - - -- x= 4 ----------------------------------------------------- - - -- -- (Signed) - - - -- -� -- - ----------------------- - � txicalInspector---------- The undersigned applicant for this building permit does hereby certify tha , e understands and accepts his ob ions 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 frorn 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. IF (Signed) -- - ----- -- - - - -- - -- -- - - - - - -- - -- - -' -------------------- - ------------ Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. 1T ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the --------------------- _--- ..---------------------------------------------- of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My 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. N° � a i .. .. CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Owner, Agent or Tenant of B i Lot Block_ Street Address, Approved use by occupancy_ Miami Shores Village, Fla., �. -T3 P. , n lincy i Remarks: QA-L.vv This Certificate of Occupancy is issued to the above name �n'llYl�.wrti.� for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. � BUILDING DIVISION op