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Multiple,� Miami Shores Village CCF 10050 N.E. 2nd Avenue 9 Miami Shores, FL 33138 -0000 s Phone: (305)795 -2204 Project Address Parcel Number Applicant 99 NE 103 Street 1121360130990 Miami Shores, FL 33138- Block: Lot PAUL BUECHELE Owner Information Address Phone Cell PAUL BUECHELE 99 NE 103 ST MIAMI SHORES FL 33138 -2326 Contractor(s) Phone Cell Phone POPEYES FENCE & CONSTRUCTION 305 - 688-3977 Yes Comments: Date Approved: 1/17/2008: Yes Date Denied: Type of Construction: Wood Fend Classification: Residential Additional Info: 5 FEET MAX Fees Due Amount CCF $1.80 Education Surcharge $0.60 Permit Fee - Wire & Wood $157.00 Scanning Fee $6.00 Technology Fee $3.93 Total: $169.33 Valuation: $ 2,300.00 Total Sq Feet 157 Total Amt Paid Amt Due $ 0.00 $ 0.00 $ 0.00 Payment Type: I 5 I�"I� Available Inspections: Inspection Type: Foundation Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated January 22, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Tuesday, January 22, 2008 »� Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FIL 4 Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 02/13! 008 Permit Type: Fence/Wall C' Inspector: Jg uvi j n Inspection Type: Final Owner: BUECHELE, PAUL E, Work Classification: Wood Fence Job Address: 99 103 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1121360130990 Project: <NONE> Block: Lot: Contractor: POPEYES FENCE & CONSTRUCTION CO Phone: 305 - 688 -3977 Buildina Department Comments WOOD FENCE 5 FEET HIGHT WITH GATES ON THE REAR TWO ON THE SIDE 14 Inspector Comments Passed �� CREATED AS REINSPECTION FOR INSP 72359. No approved permit available for inspection. No one home. 2/11/08 CGS Failed El Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Tuesday, February 12, 2008 Page 2 of 2 Bill To PAUL BUECHELE 99 NE 103 ST MIAMI SHORES, FL 33138 -2326 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: FW -2 -08 -30978 Invoice Date: February 11, 2008 Permit Number: FW -1 -08 -102 Date Fee Name Fee Type Fee Amount 02/11/2008 Reinspection Fee Fixed $75.00 Total Fees Due: $75.00 Payments Date Pay Type Check Number Amount Paid Change 02/12/2008 Check 1327 $75.00 $0.00 FEB 12 PAID Total Paid: $75.00 Total Due: $0.00 Tuesday, February 12, 2008 s P Inspection Worksheet `e n Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL �rMim, �« Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 02/11/2008 Inspector: Grande, Claudio Owner: BUECHELE, PAUL Job Address: 99103 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: POPEYES FENCE & CONSTRUCTION CO Buildina Department Comments Permit Type: FenceMall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1121360130990 Block: Lot: Phone: 305 - 688 -3977 WOOD FENCE FEET HIGHT WITH GATES ON THE REAR TWO ON THE SIDE Passed El Inspector Comments 14 < �co Failed El A4 Correction Needed �l Re- Inspection 6 Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid Friday, February 8, 2008 Page 2 of 2 Planning and Zonling Criileriia . in Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-= Yes W TPO' It Phone: (305)795-2204 Fax: (305)756-8972 Owner's Name: PAUL BUECHELE Job Address: 99 103 Street NE Miami Shores, FL 33138- ------------- Folio Number: 1121360130990 Owner's Phone: Total Square Feet: Total Job Valuation: contractor(s) Phone Primary Contractor POPEYES FENCE & CONSTRUCTION CO 305-688-3977 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 1/17/2008: Yes Comments: 157 $2,300.00 gp 1'0" I 21011 JAN 17 2000 �v:__ �!�— ®e_ 2x4 No. 3, 80. Pine PT Wood Rails Attached to Post With tour 10d Nalls (min.) CT TO COMPLIA?kE WITH ALOL FEDERAL AND COUNTY RULES AND REGULAMNS — 10' Diameter Concrete filled hole 6 4x4 No. 2 , 80. Pine PT . Spaced as follows •0*00 woo .. Fee height .. a Post 0 nc 6.. . above grade --acing • 00 o: Sol 0008.. 6660 0000 0 . 6 . :00"o 806 6 06 . of 6 0 6 66 . Wood Pickets 818" Min Thickness attached to each rail with Two 16 Ga. staples 1-14" long PERMIT #: Miami Shores Village APPROVED Y ATE ZONING DEPT � 11% e l CT TO COMPLIA?kE WITH ALOL FEDERAL AND COUNTY RULES AND REGULAMNS — 10' Diameter Concrete filled hole 6 X04 w'FFL a I Wes' la rc n ,o 6 Y � Fi � •9 mans w EOET Y480 � 7 �: /R11 �f01D AO�1'�i ••• • • • • i1• Yq/ �RRIIIi ZKORR 1/�4 RIIPY 111 bo t!! R RIlYellw,as• apurd Fs•a•IMd vM,•t w�Y•, •/p1F � F►1t• 1.0.1 •>s p KR13M g S'Ai CFRlltaf • • • i i i • • :.. • • tti,RO[ we ! PpILM 116it . Maum Hot lna aw a Yl► TF07 -➢RL me m0 BYE FM IMF V.WIFWMS"jin =M&gRE10C Aewvw rwcKuwtlecF M XF FMM TT � carm WE NOL gOR WAM2 FF *A= LOCIC1711 W FAT. EID � AbNR� 6 � M710[T 7Fil'D C•BIA d T4 9:M0 Ft1R7 f F]CNR)W FIE VW M um a d QOS IIRS Od UK IAU 0� no KiF10 OF On = R AWL. OMME 19f1M1 em o Ift 9@V►TOF II0M0 ro TI! NUM IMM Te M WU W '11affTiPl U AIN "m I1rAVt6 ICI "mwlW W! 1-ii�1 9UF.D (- 0 OiRU Ir YF na►YOY: R�!}K @ 9F7t IiM1NDb0. �IOR SEAL a CA_: M 0 Ltl 0 z I P LC N CV L.LI Q m v a 09- �o BOU �3U N.-D::A. -R-Y . • ••• • • • • ••• •• • • • • • 1W1. LL[ • • • • • !�•' '1'i'ai CL 1 �. �on� R� a' d4. MI►Oe�rq • �••q,4 ~••rsnatr :K �•,:.: � 0 i O a 9E Le ° :•�•: , w N I a It a� � � .y•• _ O F O � .4'J 1 lEf.t _ � ••r' ' Z IO 1 .•� 09 NE tai Stros! I Z I 4 Odi1'� 211 'road Ar • e. I .. °. - - ma m 1 PJte 101 tat PLO 9ti10' 1 Mr I • '��. Record Meaeur z Not ;� •:1 ,• Old "alk • ' L (..4...L � _ •8' O�,rb • de QuttfZ: • �' ' _ �. } . S : . w •�,�.' - .. •.a �7 •�'t.•' •1 .rr_ �•1� ..: '.� •• •. •, '. �•!•� 1'5.1. i••t. •` w 'i.at'eli.e'ia•a�ii ' : :••• �.��:•i.a ; � J•� >.p � •.' : •'' '' -y • ••;. ( ?b• TOW Might- oft - Way -Una ' ; h: ; •} �» GIMMIC t• IF III T r 1U4 -w N !L c%-'s ® ®cI lm r Y5� h1c�Y� tT- a ILA T; _ . •:!!mac �.a td N14. ME 103RD LOCATION SKETCH: Ab NOT TO SCALE lqw T 490 Ikk u Appendix "E" UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Contractor's Name: C'::� RZ�l 120-f)151' /4ob Address: 'Air- (Low Slope Application) ❑ (Aspbal0iberglass Shingles) ❑New Roof Re- roofing ROOF CATEGORY ❑ (Nail -On Tile) ❑ (Mortar - Adhesive Set Tile) ❑ ( Metal Roofsiwood Shingles & Shakes) ❑ (Other) � $ A4 0 Recovering ❑ Repair ❑ Maintenance s Flat Roof Area (ft) 5-0,e) / Sloped Roof Area (ft') Total (ft) —Q Master Permit No. Exposure category (per ASCE 7 -88): Building Classification category (per ASCE 7 -88 table 1'): ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed) j dAp 04flo �'P 2X q 1/3 jo a Ft. C-40 11 0-5 XJr Cie0 jai'® ;uo ROOF PLAN ---------------------- - - - - -- ----- - - - - -- --- ------------ p------------------- - - - - - � , Deck type:6 �1t✓� ; ------------------------ � r ------------ - - - - -- r ATTACHMENT FL e Fastener Type: a d rZ m., + ' SPACING - - -- ; -- , - -- - -= All Field: Perimeter: 6 Corner ` ' ------------ - - - - -' , ------ - - - - ----- - - - - - + DETAIL 1 & 2 + --_ ----------------------- - - - - -- + ' '- ----- ---------------------- - '-------------------------------- -- ------ - -- ' - - - - - ` '-------------------------------------- - - - - -' ,M, -M . am Page -1 IRld a Ventilation? MLLN HEIGHT type: J Appendix "E" AN UNIFORM ROOFING PERMIT APPLICATION PR()CFSC Tin SLOPED SYSTEM DESCRIPTION Fastener type & t Cap ROOT eLOPI D F T A I L 3 Roof \Covering: n r Drip ATTACHMENTS REQUIRED 1) Fire Directory Listing Page 2) Dade County Product Control Notice of Acceptance -Cover Sheet a) Specific System Description b) Specific System Limitation c) General Limitations d) Applicable Detail Drawings 3) Municipal Permit Application 4) Other Component Approvals (PM=I: X %1. (Aerodynamic Multiplier): ) - M9: = Mrt: PCA: (PMdX2: X. X ( Aerodynami: liultiplier): ) - M9:-=M r2: PCA: (PmaX3: X *% ( Aerodynamic Multiplier): ) - MQ: = Mr3: PCA: Page -2 PRODUCT CONTROL ANCC PRODUCT CONTROL DIVISION (305) 375.2902 FAX (305) 372.13339 GAF Materials Corporation 76%JTV mint 1361 Alps Road Wayne, N1 07470 Your application for Product Approval of: GAF Conventional Bul/t - -Up Roof Systenisfor Wood Decks 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: Dynalech Engineering, Inc., Factory Alulual Research Corporation. and Underwriters Laboratories, Inc has been recommended for acceptance by the Building Code Compliance OfTce to be used in Dade County, Florida under the specific conditions set forth on pages 240 and the standard conditions on page 41. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Building Code Compliance Once may revoke, modify. or suspend the use of such product or material immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the Building Code Compliance Ofce that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.: 97- 0804.21 Revises No.: 95- 1003.03 Expires: 11104100 aul Rodriguez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PACES FOR SPECIFIC AND GENERAL CONDITIONS • BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Office and approved by the Building Code Committee to be used in Dade County, Flori under the conditions set forth above. Charles Danger, P.E. Director Building Code Compliance Dept. Approved: 11/04/97 Metropolitan Dade County Internet mail address: postmasterebulldingcodeonline .com (M Homepage: hitp : / /www.buildingcodeonllne.com MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No... � Dow.�� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su itted for the building or other structure herein described.. This application is made in compliance mad conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all asdinaam of Miami Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein spedfied or not. A Dopy of approved plans and specificatim must be kept at building during progress of work. Owner's Name and Address �� N Stree Registered Architect and /or // Z!rj"'Zjj Street and Number where work is to be state work to be performed and purpose of building (By Fly) New Building _ »....» _ Remodeling Repabs__Ul .`.......... — No. of Stanior .................... Size Septic Teak Feet of Drain IN Nature of Water Amount of Permit I _ - -Type of Tangy ... »_ _. _.. .._._____-_..____Capacity Gals._._-._... —. _._.. st. Feet of Tank at Drain Field from Well___.. of Soakage Pit _.. Plumbing Inspector. The undersign applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida W lamer s Compensation Act, being Section 5988, Compiled Cenral Laws of Florida Permanent Supplement, and Isms com- piled with the provisions thereof. and will require similar compliance from all contractors or sub-cont; employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of work such public notice or notices as asp re p*a by t9e Act. The undersigned agrees to employ only such arb'oontractoLS Iwork under this permit, as .are licensed by Miami Shores Villaga c i Master Phuaber..�.� STATE OF FLORIDA. 1 OL COUNTY OF DADE. s Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take aclmowledgmmts. personally appeared o the well knows, and who, being n. me Brat duly care fu neon oath foregoing application, my' � � that � ap the rams, and art dl fret of the above described cons4vctrboa, that he has carefully read the therein by him stated are true, my commission Expires Notary Pubho. State of Flodda NOTE: A re- inspection fee of $1.00 will be nmade when semi s 4uPeodob it saade•naossaary by improper aetiotr far b*@CdM ar f W* mats" and/or worlanmaship. CLO$R$ BATH TUBS BNOWLII$ LAVA. Tongue SINK$ SLOP LAUNDRY URINAL{ SINK$ Tuns CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURtt CONTR• LIST CHUCK SLpnc TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR DEEP 8PRKLR. HEATER WELL BYSTLM 8WIN "S POOL T ::CK C j Size Septic Teak Feet of Drain IN Nature of Water Amount of Permit I _ - -Type of Tangy ... »_ _. _.. .._._____-_..____Capacity Gals._._-._... —. _._.. st. Feet of Tank at Drain Field from Well___.. of Soakage Pit _.. Plumbing Inspector. The undersign applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida W lamer s Compensation Act, being Section 5988, Compiled Cenral Laws of Florida Permanent Supplement, and Isms com- piled with the provisions thereof. and will require similar compliance from all contractors or sub-cont; employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of work such public notice or notices as asp re p*a by t9e Act. The undersigned agrees to employ only such arb'oontractoLS Iwork under this permit, as .are licensed by Miami Shores Villaga c i Master Phuaber..�.� STATE OF FLORIDA. 1 OL COUNTY OF DADE. s Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take aclmowledgmmts. personally appeared o the well knows, and who, being n. me Brat duly care fu neon oath foregoing application, my' � � that � ap the rams, and art dl fret of the above described cons4vctrboa, that he has carefully read the therein by him stated are true, my commission Expires Notary Pubho. State of Flodda NOTE: A re- inspection fee of $1.00 will be nmade when semi s 4uPeodob it saade•naossaary by improper aetiotr far b*@CdM ar f W* mats" and/or worlanmaship. Ni MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.--U>-3I &//y 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 Budding Ordinance of Miami Sham 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 budding during progress of work. Owner's Name and Address -- �JA, #Lck -4 J& C No. Street, Registered Architect and/or Engineer - Employing Phunber!s Name ZU&j9 641 M # S4Pjf1—C-9W-- No—& I At Street- Lamflon, and Legal Description Subdivision— Street and Number where work is to be perfmined—PIL-12A. &—A'V Strat__--. State work to be perforniell and purpose of building (By Now Building r -,-- Remodeling — Addition. Repatm- No. of Storm -_- ------ .......... Size Sepik Tank— —Type of Tank--- Feet of Drain Tfle4rf - —x fitm X Di Feet of Tw& or Drain Field from Well____ Nature of Water Supply: City Well --_Size of Soakage Pit----- Amount of Pernik (Sivied) 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 the work such public notice or notices as are reqWred by We Act. The undersigned agrees to employ only such sub- contractors, to be under this t, as are licensed by Miami Shares Village. (S l - ---- - - mow ----- bar. ------- STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, ng by me first duly sworn, upon'oath deposes and-says that he is .... . .. of the above described who, 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 Notery Public, State of Florida NOTE: A re-hispection fee of $1.00 will be made when such vs-inspection is made•necessary by improper notice for inspection, or faulty matorials and/or woffinanship. CLOSETS BATH Tuns ROWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. 'DRAIN FIELD .SOAKAGE FIT GREASIr TRAP SOLAR HEATER DEEP SPRKLR. WELL SYSTEM SWIMIG POOL COMTR. LIST CHECK 4-f` Size Sepik Tank— —Type of Tank--- Feet of Drain Tfle4rf - —x fitm X Di Feet of Tw& or Drain Field from Well____ Nature of Water Supply: City Well --_Size of Soakage Pit----- Amount of Pernik (Sivied) 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 the work such public notice or notices as are reqWred by We Act. The undersigned agrees to employ only such sub- contractors, to be under this t, as are licensed by Miami Shares Village. (S l - ---- - - mow ----- bar. ------- STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, ng by me first duly sworn, upon'oath deposes and-says that he is .... . .. of the above described who, 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 Notery Public, State of Florida NOTE: A re-hispection fee of $1.00 will be made when such vs-inspection is made•necessary by improper notice for inspection, or faulty matorials and/or woffinanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT • APPLICATION FOR BUILDING PERMIT In Application is hcrc�b made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- Sh of Miami rules and regulations of the Buildin Division of Miami Shores Village shall be rnmplied with, whether herein spetiEted not. A Dopy of plans approved (—)wnor'; Nam md h@ffWffW W11901 Andfor Name and Address 61 hed&W contitctor, Location and legal description of lot to be built on: Street and Number where work is to be State work to be done and purpose of building (by floors)- and for no other purpose. Now Building--- Reinodeling_—_ Addition 4—� Repairs.._........... No. of Stories_ To be constructed Kind of Rod Cow "H Estimated Total cost of improvements Amount of Permit Zone cubage required.______ 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 be sent — --- ----- - - - ------ --- The undersigned a p i cant for this building permit does hereby certify that he understands and accepts his obligations as an employer ec' of labor under the Flor a Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement; and has complied with the provisic:3nns ther= will require similar compliance from all contractors or sub-contractors employ by hint not. in the work to be performed under this permit; and will post or cause to be posted for inspecd on the site of the k such bu notice or notices as are require& by the Act. The undersigned agrees to employ oi-Jj such su work be P,= U= this permit as are licensed by Miami Shores Village. ep Remarks— (Signed) STATE OF FLORIDA, COUNTY OF DADE Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments, personally ap- peared to me VMU known, and who, being by me first duly oath de sworn, upon oa _poses 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 hum stated are true. Permit No- _11 I' Date-1 2- - 26 GI Read. sworn, to and Subscribed before Disapproved D e— Notary Public, State of Florida (Signed) --a.I411, Budding or My Commission PLANNING BOARD__�__... ....... ---- Chairman . ..... Member DATE Member Member Member Member Council Approved—.,--- _----Date Disapproved NOTE: A charge of $1.00 will be -mode for making carections or changes to tMs application after approval has hims obtained from the Planning Board. lik re-inspection fee of 51.00 will be charged' when snob winspee'd" to -made sieceiw7 -by, koproper no" for fikspectim at, faulw . mpterials and/or worl=�. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No '771 »....... Application is hereby made !:for the approval of the detailed statement of the plans and specifications hem-with 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 compli with, whether herein specified or not. A copy of approved* plans and specifications must be kept at building during progress. of work I = Owner's Name Registered Ardur&C-Z Employing Electrician's Location and Legal Description'tot ..... Street and Number where work is to be i.- 4 — __ / 0 3 X(L Statework to be performed and purpose of building (By Fl oors)........._ ............... . .. ............ ....... . . ....................................... . ......... . .......... . ................ New Building . ........ . ......... 1 Remodeling ................................ Addition ............................. Repairs. ................ . ................... No. of Stories.................... Service Overhea Undergrod und Size i eedera.__...._.....Conduit . ............. Main Sw ............ . ................. AAMIM .. . ....................... Main Fuses ...... . ....... . .... —....Amps Type of Installation--Conduit ...................... Tubing ....................... B.X1 ........................ Metal Moulding .. . .......... . .............. . .. . ... . .. . . .......... . ....... . ... . ...... . .. . .. . ..... . ........... . . .. . ......... . .... ................ ........... I ........ . ................................... .................... ........................ . .............. . ... . .... .... .......—I. .................. ».. ................ . ............. ......... ..... .......... ... ........................................... .......... . . ....» ............................... ......... 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 W4rkmen'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 tractors or subcontractors employed by him in the n work to be performed under this permit; .and will post or cause to be posted for inspe on the site of the work such public notice or notices I I as are required by the Act. The undersigned agrees to employ only such sub-contracto on work to be performed under this Permit, as are licensed by Miami Shores Village. _, _) 'I (Signed) STATE OF FLORIDA, COUNTY OF DADE. � 61. Before me, the undersigned authority, a notary public, duly appeared___.... .... . ...................».»»..»...» ........».................. ».. ........... »......... 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. r SWITCH OUTLETS LIGHT OUTLETS I PLUG RzcE•p•T,S FiXTURES No. LAMPS Rapitia. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER 41 TOTAL CONTR. LIST A —I CHECK sy ENT. SW. DIST. CAR, ISERVICE I Temp. SERVICE MOTORS MOTORS NEON RADIO TOTAL PERM. 0.1 HP 1.5 HP TRANS. Comm* LIST CHECK Service Overhea Undergrod und Size i eedera.__...._.....Conduit . ............. Main Sw ............ . ................. AAMIM .. . ....................... Main Fuses ...... . ....... . .... —....Amps Type of Installation--Conduit ...................... Tubing ....................... B.X1 ........................ Metal Moulding .. . .......... . .............. . .. . ... . .. . . .......... . ....... . ... . ...... . .. . .. . ..... . ........... . . .. . ......... . .... ................ ........... I ........ . ................................... .................... ........................ . .............. . ... . .... .... .......—I. .................. ».. ................ . ............. ......... ..... .......... ... ........................................... .......... . . ....» ............................... ......... 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 W4rkmen'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 tractors or subcontractors employed by him in the n work to be performed under this permit; .and will post or cause to be posted for inspe on the site of the work such public notice or notices I I as are required by the Act. The undersigned agrees to employ only such sub-contracto on work to be performed under this Permit, as are licensed by Miami Shores Village. _, _) 'I (Signed) STATE OF FLORIDA, COUNTY OF DADE. � 61. Before me, the undersigned authority, a notary public, duly appeared___.... .... . ...................».»»..»...» ........».................. ».. ........... »......... 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. r I 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 h ein described. This application is made in compliance and conformity with the $wilding Ordinaaee of Miami Shores Village, Florida, d all provisions of the Laws of the State'oE Florida all ordinances of Miami Shores Village and all rules and r'1g01" ons of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approv plans sari specifications must be kept at building during progress of the work. 0—wi?er s N &Mq and Add Cry �- � i✓ " ' c " f G " ` lt�1lt! BH�r'b @llItllillf,i�. i tau }suunutuw}u }�u} uslUwuuuiutut :Miou}xaKt}i}xi7wi}�..:} t�}a+�}fiu+u►�.+� Name and address of licensed contractor..... ._.. C ,, y i� /� /Df1 3! d dU°G9.' 1/2 �jyr r Location and legal desertion $Blot to be built on: % r Lot ! °T . S-/-/ ._„ uvson_ Street and Humber where work is to be done........ 2 -2, O1/- State work to be done and purpose of building (by floors).... _ 4 D 0 %jam >tf ».._.»... ».._ _.».._�....._...... and for no other pnrposa New Building-...--- Remodeling.»».». „. Addition_....._»............„ paint....... ». Re No. of Stories...... To be constructed of »..... ».... »...» . Kind of foundatioa.,p..„.�, covering--"o Estimated Total cost of improvements Amount of Permit $. •..• --.= Zone cubage required»„,...........» .».. _ .... ......_...._.Ylan Cubage_..... Durance to neat nearest building .... _........ _.._,_Size of Building Lot.».. X 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-... k .Cf : D .. .�'�.t d? M i b p� :3 / l /.. »!V,' -C °` :...... C. % The undersigned applicant for this building g p� g permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968; Compiled General Laws of Florida, Pennanrr}t Supplenient. r and has complied with tl a 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 suchpublic notice or notices as a required by the Act. The undersigned agrees to employ only such work to be ' permit, as are Ilicensed by Miami Shores Village. pvfarmeduunder this - Remarks- STATE OF FLORIDA,' COUNTY OF DADE. i •.; Before me, the undersigned authority,.a notary public, duly authorized to administer oaths and take ackaow 3 ` geared ledgments.. persottaliy ap- • ;1 »... me well ..F 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 std dj therein by him stated are' true. / ry °� Permit No -- .Date._. J..L._ .._,.� .�: < Sworn to and Subscribed before me. i. Disapproved Date _.. _ (Signed) Notary Public. State of Florida ; . r ' Building Inspector M Cwn}mission Expires PL BOARD » ..._._.�...:.r�ATE Chairman ._ _ .. „... : Member .»..,_. _.......� „ .... . Member_.__ ._ .... M ember .. ............. Member ..... Y....._..... Council App _ .. .».. „ Member -- ................ ....Date Disapproved ........._.. ._........_............�....,,; „...»._..._Date NOTE: A charge of $1.00 will be made for making corrections or changer to this application after approval has been obtained from the Planning Board. I A reinspecoon fee of $1.00 will be charged When such re- inspection is made necessary by knprq et, pollee for � a �Y materials and /or workmanship. r �.��,� x 3� °�- � =��5�- ?gam Abe MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereh n adq for tipo approval of the detailed slata.�a•nc yr one ptaos and specifications herewith submitted for the build inc or other structure herein described. Tlpis application is made in compliance and conformity with the Building Ordinance of Miami 3+tiores Village, l7orida. ;and all provisions of tlpc Laws of the State of Florida, all ordinances of Miaml Shores Village and all rules and regulations of the iiuildicig Division of Miami Shores Viilaaggo shall ba complied with, whether herein speedfied or trot. A copy of approval plans and specifications must be kept at building during pingrers of the work. Date_. ........t�.q.G..»_._«........ Ou.-nei s Name and Add�cw .........�,�vG U Cf{ GE. „+..:....._„...»............ No..„....�gi�„«........ Street ��... T .. „. Registered Architect and /or ti'tli; racer•••• . ............. . «.....„ ....,. « « «•«•enr••«sn•mxe.n : rnwe•, semt�ems . .......................... Name and address of licensed controctor ....... ..n 1ex-t .» t o FI ND- (� D•jk . w,3� NW ZI Location and legal descriiption of lotto be built on: Lot........... ... „................. ».,I...... Block. „.......... ..... „ „.....» Subdivision ... »....... ».».»:........ .......:....... Street and Number where work is to be done..._...„ 72 N»._. f „103 - ._•ST ._... -�--, State work to be done and purpose of building (by floors). 2E �. „��R...Ar. �».....��— »... -•.-- .��V�L ...-•. »».....»_»».._...... ...... ........ ........ .,.„. ........... . ... _........ « »...... » .................» ...........»._. l _ ..... ..... .................. .. ......... »._..„ . „ ».... ... turd for no other purpose. New Building ............................ Remodeling ..._ .......... .. .. Addition................. .... Repairs:.. ....... ✓ No. of Stories...... / ..._ To-be constructed of ...l . ............... Kind of foundation :».... ». ............................. .... » .... _ 'Roof Covering..........:......... .."... Estimated Total cost of improvements $..........1.;P0' X ...._...__...- ....Amount of Permit k... _......»„.�0' �«» .................... ............... ..._ „ »... 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 i besent to.; . ......... ...... ............................................................................. .................................. _.............................................. .. .......... The timiersigrncd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the I:lor da Workmen's Compensation Act, being Section 5966, Compiled General haws of Florida. Pennanrnt Sup plrinent, and has complied with he provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint in the work to be perfo mcd 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 >yy Miami Shores Village. W — Remarks..._._.....„ .. :.. .. »...._ „„»»_._„.. ( Signed � STATE OF FLORIDA CQUNTY OF DADE. ss. .Before me, the undersigned authority, a notary public, duly authorized to administer oaths and .take acknowledgments, persoeally op- peared»».._........... ...... ........................... ._.... ......... ........._ .................. » »...» �_.._» ._... _........»... ....._ .»...... _.. _ ..._ ............._. » ............... _ —to me well lmown. and who, by me first duly sworn, upon oath deposes and says that he is the ......................:................. ........ ».. ».».... »......:....» ..».._..„ of the shove described construction, that lie has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stat aria true.. Permit No. � . _..._... Date.-� . „ Read. Sworn to and Subscribed before me. Disapproved .. » '° @.. . _ ..... ».»v.� . �!_Date_ _— ---- .. - - - - ». - - - - -- Notary PublicState .oForida (Signed) w' _ ...... ....„....«...„„».,..._...,.�.» Building Inspector My Commission Expires. PLANNING BOARD„ ............................... DATE Chairman..» .. .. ........ ... » „...._.._......,. ..»„„. Member _.....«...„. ,...... ».. „..„.......�,„.........».... ,. .Member ....... Member _.......»..... �.„.» ..... „» ...... »...... ,Member ................ ..._...... _.... _.„. _ Member » ._ ... «.»„....._..„..,.....„ »_» . »..... �... . Council Approved ..... .w.._ ,,..:... »..._.. ».._... „ . »...._......Date Disapproved ...».» .. ».._......»». ...... ........................ .......Dale NOT F.: A charge iof $1.00 will be made for making corrections or changes to this application after approval has 6vn obtained from the I lannin_ Bum& A re-inspection fee of 51.00 will bey charged when such r&hupection is made tweessary by Improper notice for inspection or faulty . materials anti/or work ip. i Canes ar'3 Ysm� 2g e Rot, A(G Too A,&Lmr. 03r Ale I 3nng :�T�'r -s�Rv C (Low aIOCC t�DL1i:C..'riCiII u: 2'.`:�Ii rltc 1 c t C (lsaait�F� St�des� C(l f'_�ai .' c' • s) C(C k=j C 'New Roai Q R&-rva a; CR�uveria -7 AS 7-U).- Bmiamg C=ssffc 'am=mgm7 (p,-- ASM :-.fig table Jx ROOF EMG33T A:n SYSTMI DL-f- I,,$ 00mv damn = ce:res� Ft ! GOOF FAY ------------------------------------------- -- ----------------- �, - - - -- ; '------------------------- - - - - -- ;' Deck 1 tt, t , t , t , 1 ' ` i----- - - - - -- ----------- ' 1,', 1 L AA TTA f'fiV ^YT _ 1 , t 1 ' , 1 �,i ►'tt ; i t 1• t. Fnstcter f ' 1' r t �• � t; t�; t �� ti, �. t t;, l t �. e a r t SPA rT-!Vr U}�j�_ ' t ' , ' ' 1 ' 1 ' t • t ' f ' t ' t ' t ' a t t • ' • 1 ' + ---------------- - - - - -= ' , t • , ' , t 1 1 {------------ ------- - - -- -- / " 1 1 ••, 1 1 1, 1 • ' ' •--- - - - - -- -------- - - - - -- i, 1 D ET�iIL 2 3c " "'" t P • . ---------------------------- - - - - -- 1 --------------- ----------------------- f.:cudc - for- --r Ind AdSc ireSc:iue ' - - - -- 5104 APPENDIX "F" APPENDIX "F "REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS As it pertains to this Appendix "F ", it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form. The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. 1. Aesthetics - Workmanship: The workmanship provisions of Chapter 34 are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 29 of the SFBC. (The*roof deck is usually concealed prior to removing the existing roof system) 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 25-1 4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The SFBC provides the option of maintaining this appearance. 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. , & 5. Overflow Scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with Chapter 23 of the SFBC. La 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. d Owner's /Agent's Signature Date Contractor's Signature Signature DATE: Qtr MIAMI SHORES VILLAGE Paint Color Approval and Agreement ►/ -7 67 ADDRESS OF SITE: q 9� AIE, / ® 9 S+, CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Soffit Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings Other 0 °r W rn ro r rn H H x Z C3 9 M x 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 saes. � Signature of Owner Date Signature of Contractor Date APPROVED: /p Building cial Dat WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION -7 SOMM SERVICES EL NCOTESTINGANDE14GE Lab or atory C cafiwi ertifi No. 00-1102,03 01--�'he,'-r' �,'I't�,AT-ET) 1411AF-i i, U c ,STING ON ROOF TILE RUMU, TO ('011PIA' Al ITH RI ETRO-lb,f?!" =UNTV PROTOCOL PA-106 XCL PROPERTYADDRM. 102 NE 103 St (Miami Shores) PERAETNo: 49277 OWNER: Wwdard, Mark PCA No: 21-25 CONTRACTOR: S&J Roofing Contractors, Inc. ROOFPITUP 4/12 ROOFING SQUARES: 12.78 sq "ECHONDATE; 08115101 ME TYPE. Santa F6 TEST DATE: 08/27/01 CONTACT PERSON Yusi (305)205-0327 JOB NUMBER; R-0109176' TEST RESULT TABULATION Tes inn Ecajhjnie,i, Doi; a i-rizWlo- -X. Reowred Testinn Force. 35 It UMKL"ktMk'AbbhLU kAILAIAU 'I'tffiNEAMUFLLFI'INAUL;UWANUEWII:kiMLAMI-I)AJJJhL;UUN-i.YkAIU(). TCH- K'0( is 6 5 2 1 5 L 15 23 12 \-14 X3 10 19 20 14 16 16 21 6 a li 13 Is 17 is " 22 - 24 21 • 32 30 25 36 38 34 28 27 20 39 /411 35 33 31 29 2 11 ' 44 37 — 42 45 j 25 6 43 07 15 �XAI-6riinez rsi c I EnoeerNo. 0031509 13380 SW 131 Street, Suite 120, Miami, FL 33186 Voice: (305) 259-9779 Fax: 1-8664336988 RUMU, No. UFAILT- XCL RMLT N 0 la 1-5 Passed 21-25 Passed 41-45 Passed 61-65 81-85 6-10 Passed 26-30 Passed 46-50 66-70 8690 11-15 Passed 31-35 Passed 51-55 71-75 91-95, 16-20 Passed 36-40 passed 56-60 76-80 95-100 UMKL"ktMk'AbbhLU kAILAIAU 'I'tffiNEAMUFLLFI'INAUL;UWANUEWII:kiMLAMI-I)AJJJhL;UUN-i.YkAIU(). TCH- K'0( is 6 5 2 1 5 L 15 23 12 \-14 X3 10 19 20 14 16 16 21 6 a li 13 Is 17 is " 22 - 24 21 • 32 30 25 36 38 34 28 27 20 39 /411 35 33 31 29 2 11 ' 44 37 — 42 45 j 25 6 43 07 15 �XAI-6riinez rsi c I EnoeerNo. 0031509 13380 SW 131 Street, Suite 120, Miami, FL 33186 Voice: (305) 259-9779 Fax: 1-8664336988 m Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/15 /2002 Applicant: A BERENICE Owner: BUECHELE JOB ADDRESS: 99 NE 103 Contractor KAWALEK PAUL Local Phone. 305 -218 -3552 Parcel# 112136030990 Building Permit Permit Number: BP2002 -1247 Page 1 of 1 BUECHELE A BERENICE ST Contractor's Address: 485 NE 92 ST * * ** Legal Description.: MIAMI SHORES SEC 5 PB 10-47 LOT 23 & E1 /2 LOT 22 BLK 123 LOT SIZE Fees. Description Amount FEE2002 -3908 Building Permit Application Fee $60.00 FEE2002- 3909.. CCF $1.20 FEE2002 -3910 Notary Fee $5.00 Total Fees: $66.20 Permit Status: Approved Permit Expiration: 1/11/2003 Construction Value: $1,100.00 Work: VALLEY GUTTER VALLEY REPAIR Total Fees: $66.20 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit Is granted Is the understanding th at 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. C 1J 9 G (INSPECTOR) BY: Signed: ' In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: N. 5 PAUL &- KAWALEK ROOFING & PAINTING 2789 485 N.E. 92ND STREET PH. 305- 754-0191 j `� MIAMI SHORES, FL 33138 -2566 1/�1 63- 27/631 FL ` r Date 810 Pay to the order or yy \ / f l a o BankofAnae is ,f- V� gy�a�s -�-i 13� iV� b }kFp503 Tt-� 4*- r c wr+ooze (� Q ,3q5 A� 1:063100 2? ?1: 00 366060 19 14,15 2 ?89 ' L Florida Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit , plication Form. INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND . ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: R oof System Required ; Low Slope Application Permit A Prescriptive BUR -RAS 150 1,2,3,4,5,6,7 Asphaltic Shingles 4,5,6,7 yB,D 1,2,4,5,6,7 Concrete or Clay The-A , etal Roofs 1,2,3,4,5,6,7 ood Shingles and FShakkes q 1,2,3,4,5,6,7 her As AE sections of the . Attachments Required 111cation Form See List Below 1,B,C 1,2,3,4,5,6,7 L,B,C 4,5,6,7 yB,D 1,2,4,5,6,7 B,D,._ 1.2.3.4.5,6,7 ,B,D n 1,2,3,4,5,6,7 ,B,D .: 1,2,4,5,6,7 ►plicable 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED::= -� I. I Fire Directory Listing Page 2. From Notice of Acceptance. Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 4 1 Design Calculations per Chapter 16, or If Applicable, RAS 127 or 16.0wRAS 128 ners EOther C-- -----t Notice of Acce tances ici al Permit Application Notification for Roofing Considerations Re- Roofin Onl 7. I. Any Required Roof Testing /Calculation Documentation Florida Building Code Edition 2002 High Velocity Hurricane Zone uniform Permit application Form. Sectiory C Low loped Roof S stem Fill in Specific Roof Assembly Components and Identify Manufacturer - (If a component is not used, identify as "NA ") System Manufacturer. NOA No.: 'Design Wind Pressures, From RAS 128 or Calculations: PmaY1: pm2r3:_ pw2X3. Max. Design Pressure, From the Specific NOA System: Deck: Type: Gauge/Thickness: Slope: Anchor /Base Sheet $ No, of Ply(s): Anchor /Base Sheet Fastener/Bonding Material: Insulation Base layer: Base Insulation Size and Thickness: Base Insulation Fastener /Bonding Material: Top Insulation Layer: Top Insulation Size and Thickness: Top Insulation Fastener /Bonding Material: Base Sheet(s) & No. of Ply($): Base Sheet Fastener /Bonding Material: . Ply Sheet Fastener/Bonding Material: Top Pty: Top Ply Fastener / Bonding Material: Surfacing:. Fastener Spacing for Anchor /Base•Sheet Attachment Field: —" oc @ Lap, # Rows @ ° oc perimeter. ° oc @ kap, # Rows ° oc Comer. - - -"oc @ Lap, # Rows @ ^ oc Number of Fasteners Per Insulation Board Field Perimeter_ Corner Illustrate Components Noted and Details as�Appllcable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter- Flashing, Copm g, Etc. Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Materials Thickness, Fastener Type, Fastener Spacing or Submit Manufacturers Details that Comply with RAS 111 and Chapter 16. /� Height rjoriga Building Code Edition 2002 High Velocity Hurricane Zone Uniform Permit Anolication on D Stahn Sloped Roof Svsti 5•J Deck Type: ype Underlayment: R oo Insulation: 12 Fire Barrier: Ridge Ventilation? Fasten \A Mean Roof Height: Type & Sp OsivP Tyl;; ,Type Cap r ..- -- I ype & Size Drip dge: = -1 I Florida Building Code Edition 2002 l High Velocity Hurricane Zone Uniform Permit A lication Form. Section A (General Information) Master. Permit No. Process N . Contractor's Name _ Job Address . ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ❑ Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof Re- Roofing ❑ Recovering VRepaIr ❑ Maintenance ROOF SYSTEM INFORIiIIpiTION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, si%plevels, pers, overflow scuppers and overflow drains. Include dimensions of sections clearly' identify dimensions of elevated pressure zones and location of parapets. 4 - t4 z _ 4-4.L j 1i t 7 — i _ ..L..... �t _ 1 7�}•— •c•`.'' 7i- r -t_ _ t ' t — r -r v .+- s. t t _ j •'—L �I� Florida Building Code Edition 2002 elocity Hurricane Zone Uniform Permit AnnliraHnn Section E Tile Calculations For Moment based tile systems, choose either Method 1 or 2. Compared the values for Mr with the values from Mf- If the Mr values are greater than or equal to the Mr values, for each area of the roof, then the file attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per PAS 127 ". ------ —)vigc a Mrt NOA Mr (Pz: x �. _ _) _ Mg: ° Mr: x x NOA M .. (Pa� M r — - -) — g: = Mr3 NOA Mr Method 2 "Simplified Tile Calculation Per Table Below" - Required Moment of Resistance (Mr) From Table Below NOA Mr *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F%with the values for Fr. If the F' values are greater than or equal to the Fr values, a>r each area of the roof, then the file attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" x w: _ ._) — W: x cos 0.• = Fr1: NOA F' (P2: x 1: —=—x w: (Pa � x 1 • _ — _—} — `V: x cos 0.• = F,2• NOA F' x w: = --) — R': x cos 0. _ Fr3: NOA F Description Where to Obtain Information abol Where to find rressure 30' • . 4p' E- 39.7 42.2 37.4 • 39.8 15.1 37.3 12.8- 34.9 10.5 32.4 !8.2 30.0 *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F%with the values for Fr. If the F' values are greater than or equal to the Fr values, a>r each area of the roof, then the file attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" x w: _ ._) — W: x cos 0.• = Fr1: NOA F' (P2: x 1: —=—x w: (Pa � x 1 • _ — _—} — `V: x cos 0.• = F,2• NOA F' x w: = --) — R': x cos 0. _ Fr3: NOA F Description Where to Obtain Information abol Where to find rressure P or P2 or P3 RAS 12-, � y tt H Job Site �B]Ope 0 Job Site plier I NOA due to 411e weigh[ W NOA le Dimensions 1= length N0.4 �� =wdth be submitted to the 13u11din Official at the time or by an PE based c-. SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING • CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. 1. Aesthetics- Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. Ar2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may -have to be Ten'-ailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system).. 1Z3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be sewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. ;ie 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the oF6.oofing system is removed. Ponding conditions should be corrected. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in acc rdance with the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. ; Contractor's Signature Qj Owner's/Agent's Signature Date C:IOO"L ,IEdtemOLOCALS- I%T,.pISECTIO\ 15:4.4u SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the cohtdnt of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and..standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. 1. Aesthetics- Workmanship: The workmanship provisions of Chapter 15 Nigh Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be a dressed as part of the agreement between the owner and the contractor. Af2. Renalling Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). 2!�K.3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, -the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 14eg' 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the optioD of maintaining this appearance. AK5. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in lows -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. �0_6. Overnow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. ' Q� O%ner's/Agent's Signature Date Contractor's Signature e..toocC ale- I%"ILoeaLsJ%Tt.AEerw. IM4 T t MkAM1 SHORES VILLA .' BUILDING- INSPECTION DEPARTMENTT APPLICATION FOR BUILDING PE*MIT Application is hereby made for the approval of the detailed statement of the plans and specificat in or other structure herein described. This application is made in compliance and conformity wii Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Mi regulations of the Building Division of Miami Shores Village shall be complied with, whether herein plans and specifications must be kept at building during progress of the work. t Date - - - - -- -- - - -I-- - , - 119- p � Owner's Name and Address %%- ! � -A /V LJ ----------------------------------- No. Q -- - - - - -- Street --- lt l %r 7fL. Registered Architect and /or Engineer-------------------------------------------------------------------------------- ------------------------ - - - --- --- - - - - -- Name and address of licensed contractor ----- lVA- -- R----- -A-LLD L -C- Ac------------------------------------------ -------- ------ ---------- - - - - -- --------------- - - - --- Ls herewith submitted for the build - the Building Ordinance of Miami Shores Village and all rules and ec �fied or not. A copy of approved g description of lot t Location and legal d o be z Street and Number where work is to be State work to be done and purpose of building b floors ___ _ �_ I N _ ____ �?_ ____ -----__" ------------------------------- e-_______________ PrP g( y ) ------------------------------------------------------------------------------------------------------ ------------------------------------------- --------- ----- ----- ---- -- -- ----- -- - - -- --and for no other purpose. New Building --------- � ------------- Remodeling --------------------------- Addition------------------- - - - --- Repairs-- ------------ ----- - - - - -- No. of Stories ---- 0 ------------------- To be constructed of_ C__Q_a' ----------- Kind of foundation r v? ___ig: !_Y1L___A_f11VJ __ Roof If � _ r 'f__ Estimated Total cost of improvements $__ __L'y__d_ ®- __ __ _______ Amount of Permit $ ___[__� __:- __ - --- --- - -- - Zone cubage required----------------------------- Q-- ----- -- - - - -- --Plan Cubage- - - - - --- - - -- f..}M - ---------------- - - - -- 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 constructiol -amay be sent The undersigned applicant for this building permit does hereby certify that he u dersta ds'and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Com led ne 1 Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance fro al co ractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted fo ins on on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only s u c actors, w to be performed un er 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 did sign the same, and that all facts therein by him stated are true. No Permit- -- ---- -- --- 11\1 - -- -- _ _ti '_ ______ ate_ ____ f fv ad, Sworn to and Subscribed before me. - Disapproved- -- - e - - ------------------------------------------------------------ = - - - -- -- - - - - -- - - - - - -- - - - - - -- Notary Public, State of Florida ( Signed) - - - - - -- -- - - -- - -- - 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. // -2 13 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hercl,y uinde for the approyil of the detailed statumvnr ur tru plans and specifications herewith submitted for the build inq or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florid.r, and all provisions of the Laws C4 the State of Florida, all ordinances of Miami Shores Village and all rules and reguLttions 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 progress of the work. Date ... June r10_, 1983 Ovc•ner's Name arui Address Ivlr. P. Bueehele ...... ». No.... »... »..... ».._ ». Street 9......N._...... »..........._. • 9 N.E. .. St rooter Rcgcrtercd d4"MKand /or Engineer pierce Roof in a, Inc. � ............................................... .............................. Name and address of licensed contr�,tol,Pierce_ Roofing Inc. 2721 S.W. 69 Court Miami, FL. Location and legal description of lot to be built on; Lot.... ...................................... . Block.. ............................... Subdivision ..................... _ ................... - _..__._.._»_....._._....... .... ................. _......_.. Street and Dumber where work is to be done, ....99 N.E. 103 Street — Mimai Shores, Florida .._.. ».» ._ . _ State work to lx done and purpose of building (by floors).. Re -Roo. ng..work....gging, )gack with Flat white ... tile. 29 squares. _ ............................................................................•........._..-_--_-_.................-.... ............................... ........_....._.............and for no other purpose. New Building ....... .. .... g ............... ....... ......... Repairs No. of Stories ., -.One Remodeling Addition ............... _ To be constructed of ..._ ..... ........ Kind of foundation .................. ... ..... ................................ _. Roof Covering ............... ..... ... ........ ... _..-- Estimatcd Total cost of improvements 5..6.e. 540..0.0 ....................... Amount of Permit S... Aa........._ .............................. . .................... _........ Zonecubage required ..... ......................------.... ............................... .......plan Cubage ................................................. .............. _.. ..... .................. Distance-to next nearest building.......... _. ............................. _........_.....Size of Building Lot ...................... - ..... _ .......... ._ ..... ..... .......... ... ......... _ Maximumlive load to be bome 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.. Pierce._, Roofi .ng ....... I,nc... ...... .7.2..... S... W.... 1 _69...Court..... Miami., .... F1. orida 33155. Tire undcr.igncd apphc,; nt for this building permit does hereby certify that he understands and accepts his obligations as an employer of Libor under the Florida Workmen's Corm pen sat ion Act, being Section 5966, Compiled General Laws of Florida. Yernxnent Sopplement, anti has cominccd with the provisions thereof, and will require sunilar Lomrpliance from all contractors or sub - contractors employed by him m tl•c 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) .... _ ...... _._.__. CC: C- 024404 STATE OF FLORIDA, t ss: 261 -96 -7280 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared........ DQ.. nald ... D.... Q. reenleaf ...... ............................. ......................................................___--.-...__-- ...._.- .._..------- ..---- - -._.. _.........._._.... - - _._ .... ..............._..........------- .... - .... .................. _ ....... - .......... _ .................. - --.....to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . ....... Supervisor .................. ........I.... ......... _........ of the above described construction, that lie has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.._.1. .a?;�.1t ................... Date.... ......1. �....... .......... _._ Read, Sworn to and Subscribed before mt. Disapproved.....:. _. _..._� Date.-_..--- -._.. ........ _... .............. ................. N ..... ..... _...._........_.. a. Notary Public, State of Florida ,. 1 Y . .. ;Signed) ..............:....... _............. ............................... Nola Publi + Building Inspector My Commission Expires ... Ny �lninisslvri Expire iVovembt?tK r�1J8S PLANNING BOARD. ..................... .... ................ -_......DATE Bonded chit Maynard Bonding Agency Citainnan ........ .................. _ ............................... _ ......... .. ..... ............ Member ....... ........................ _._ .... _ ........................... _.. »..._......... »..._ Merr,ber ..... ..........................._............................. .._.._............•........_... Membcr ....... _ ...................... .................. _ ... _ ............ __ ..................... _ Member... I ......... ................................_.. ...--- ...._..._._.............. Member .... _ ................ —..--- ------------ __ --------- _ .................. _...:_ ... ..... CouncilApproved ............. ...... .............................._ -•---.................Date Disapproved ...... ...................... ............................ ....... ... ........ .Date NOT F,: A charge of $1.00 will be made for making corrections or changes to this application after Approval has been obtained fmtn tilt Piavllir.g 1luard. A rc- imprction fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materiaiy and /or workmanship. CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami hores Village, F Owner, Agent or Tenant of Building Lot f: f .•. Block Subdivision Street Address Approved use by occupancy ° ✓" Remarks: This Certificate of Occupancy is issued to th above named for building at above named location only upo i the express provision that the applicant will abide by and comply with all conditions of Ord nances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ord nances. of Miami Shores Village pertaining to the erection, construction, alteration or remodel g buildings or structures. t BUWtING DIV ION MIAMI SNORES VILLAGE, FLORIDA BUILDING F1 DATE 4 19 -- ELECTRICAL ❑ PLUMBING ❑ PERMIT N Y 6833 Contractor's License No. — ROOFING ❑ ❑ Work to be performed under this Permit— __-- _____ — Owner of Building Architect _ Contractor or Builder ` 11``` Legal Lot II Subdi- Description Bl. vision Address of Value of 11 Amount of Building Project $— 11 Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: _ — -- INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances cmd 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 0T ' uric DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: Md 8/16/49 X OW;NER'S NAME TYPE C�v PRESENT ADDRESS LICENSE NO. PHONE NO. AIDUCK, HAM I 190 N. W. 162nd Street - ' ADDITION JOB LOCATION (ST. OR AVE.) APPROVED LOT =COUNCIL BLOCK RE- SUBMITTED TO PLANNING BOARD SUBDIVISION 99 N. E. 103rd Street 2'&E .i22 I 123 1 -diami Shores 799 GENERAL CONTRACTOR BY JDH I TO Harry Aiduck. 9,9 NE 103rd Sty ADDRESS PHONE NO. LICENSE NO. Ormer I 190 N '10 162nd Street I 3314 BUILDER'S BOND BUILDING PERMIT p NO. 81:.}.9 DATE p 8 /lo /tl.'`9 p PERMIT FEE S 13.00 NO. 861 DATE 8/16/49 ZONE PEQUIREMENTS 17,500 CU. FT. PLAN CUBE 26,0501 CU FT. EST COSTS 149000000 uric DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: Md 8/16/49 X I NEW CONSTRUCTION I TYPE C�v STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION 1 I ?a.rrel Tile P laster +a11s - Terrazzo 1' lours REPAIRS Liv DESCR IPTION Rn -Din Preh- Kit -4 3ed Rtns- 2 ; BUILDING INSPEC_TIANC INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION Zl ! 9 JDH DATE FEE TEMPORARY SERVICE BEAMS & LINTELS _9Z2VI43 .JM SEPTIC TANK Owner 8172 8/24 49 FRAMING 0 21 $ /7 SOLAR HEATER G `y Dp 828 MOTORS 9L2WO $ 2 00 GAS , FINAL 1121 14 4 .I DH p 8 2 10 10 CLEAN -UP INSPECTIONS DATE YY RE- INSPECT BY RE-INSPECT PLUM13ING PFFYMITC A. ING�Re^TIAw�� CONTRACTOR Plumbing Go. PHONEQ pMcGuire PERMIT NO. 818 DATE 8 2 49 �7 FEE $ /- 5 NEW BLDG. X ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK Owner 8172 8/24 49 $ 1.00 SEWER RANGE CONN. $ /7 SOLAR HEATER G `y Dp 828 MOTORS 9L2WO $ 2 00 GAS $ FIXTURES $ Dr Woo p 8 2 10 10 $ 1.00 INSPECTIONS DATE YY RE- INSPECT BY RE-INSPECT BY ROUGHING 1 RE- INSPECT �1B JM to out 1 1 TM JLi GAS ROUGHING 10 2 SEWER H. W. HEATER CONN SEPTIC TANK 8 �1 �!- v ✓al.. RANGE CONN. SOLAR HEATER FIXTURES p 12 V J T L[7 FIXTURES & FINAL 12 S JDH D= w1all 49 JDH ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR Bent LlAntviA _PERMIT NO. X80_ 1 DATE 1020,149 FEE $ 14• NEW BLDG. iC I ALTERATION I 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 1 JLi ROUGHING 10 2 H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL 12 S JDH APPROVAL TO POWER CO. FOR SERVICE DATE 12/8/19 BY JDH ADDRESS99 N. E. 103rd St. LEGALLot a2l22- 23,H1k.123. ,Mssys- RECORD GARBAGE TAX ctf . occ 12— 4-PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER Harry Aiduck (o) /9i a. 00 a -3/- 79 �¢ /p / %7 9 13V9, << s 3 /•s� �� la 3 •5/ . /lv MIAMI SHORES VILLAGE, FLORID BUILDING DAT '� �� 194 ELECTRICAL PERMIT N° 8183 Contractor's PLUMBING License No. Work to be performed under this Permit_T�, Owner of Building Architect Contractor or Builder Legal Lot BI. ' Description Address of Subdi- vision Value of Amt. of T , � Permit pei it 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. CZ.� Signed:'- "" —. BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform t , work covered hereunder in compliance with ally a es and re g I� s >n pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities f_ l fami Shores�Villag�. In accepting this permit I assume responsibility for all -work done by either myself, my agent, servant or employee. ' 'CONTRACTOR OR BUILDER BY _ AUTHORITY /,5 MIAMI SHORES VILLAGE, FLORIDA BUILDING .A DATE ELECTRICAL PERMIT N° 8172 Contractor's License No. PLUMBING (1JL1 Work to be performed under this Permi Owner of Building Architect Contractor r or Builder Legal Description Address of Lot Bl. ^ Subdi- vision Value of Amt. of 'Z /! Permit J =' 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'. By- INSPEtTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all drdinances and regula ' ns,- J pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorifiiR of Miami Shor�s:�ll e: In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. f CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE,-.I %�-<-,,, r / G • 194_ ELECTRICAL, PERMIT N° 8149 Contractor's PLUMBING.icense No. Work to be performed under this Permit Owner of % Building r i Architect � Contractor / '� or Builder Legal Lot Description �X' Address of Bl. Subdi- - - vision wig Value Protect f /V :. II Amt. of t f °""°�` �` Permit This per'Kit 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: , �,.4 By -�/I INSPECTOR r In consideration of the issuance to me of this permit I agree to perform ttie ork covered hereunder in compliance with RRrdinances annt�ii rr��ggyyl1��tt�ns pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorittiit of Miami S orb3'�31I' e. S In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. r .4 CONTRIKCTOR OR BUILDE BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE 194 — ELECTRICAL PERMIT N? 8977 Contractor's PLUMBING License No. Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Bl. Subdi- Description vision Address of Value of Amt. of Building Project il 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: 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 Issue 1914 Amount — No. Houses �— aiami Jhores7illage F L O R I D A BUILDER'S BOND KNOW ALL MEN BY THESE PRESENTS, that /I? ^ —,)V) "Z�% N® 861 in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construct or repair a building or bu' ings at the following addresses: do hereby deposit with Miami Shores Village, Florida, the sum of�_�� , and I agree with said Village that, when such construction shall have been completed by me within the meaning of the ordinances of said Village, I will clear all premises and repair any Village property damaged by me, used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the completion of such constructLan _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 aforesai `� , 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 --) day of (Seal) INSTRUCTIONS TO BUILDER —When above mentioned construction is completed and the premi es are cleared and repaired take this bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your 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 befojA commencing said construction. WHEN CLEARED AND REPAIRED BY THE VILLAGGE(J Amount of Bond. . . . . . . . . . . $ Cost of clearing and repairs done by Village $ Balance due Builder . . . . . . . . . . $ ` Building By Village -_ 1 PERMIT APPLICATION Master Permit No. Subsidiary Permit NoA V. d` D Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the com letd 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. x Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building New Construction Electrical Enclosure Mechanical Alteration Exterior Plumbing Repair LPGX Alteration Interior Roofing Demolish Fence Relocation of Structure Other Shell Only ARCHITECT Name License No. Address Telephone Fax VDescription of Work vw Icy kepoi r- Zoning Linear Feet Square Feet Units Floors Walue of Work bF pr Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension PROPERTY OWNE Name �y 3 Address [�' 77 Home Telephbne Business Telephone Fax TYPE OF MANAGEMENT (./) New Construction /+t Enclosure License No. Alteration Exterior Address Repair Telephone Alteration Interior Qualifier Name Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'] Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name /+t License No. Address Telephone �Q' Fax Qualifier Name �r, ` Page 2 PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the streettsidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT Please Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLIORIDA, COUNTY OF MIAMI -DADE Ilk Signature of Owner Print Name % Swom�to` and subscribed before me this l_ day of �tgnaturT c Tp A�Rblic -10MAt V - 4 MN' ?X .A M tt C i1� \i `r(S f%?N)'�8,`.wAG7! rsc+tBL rw SEAL: ��Y �}SS.i3M9(r"Mfar= OF ftiLy i x? Personally known OR, Produced Identification Type of Identification Produced: Signature of tractor / ual' ie ' { (A-/ LA.; Print Name and subscribed before me this day - n ' Of SEAL: �9R 1a pt t p s CKF,il 7 "�� Personally known V OR, Protkiged Identification Type of Identification Produced: M Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. Minimum Fee TYPE Dryer QTY. TYPE Outlet, Appliance QI'Y. 'I-N Pf'] Service Repair Q-1 N'. A/C Central 1 -3 Ton A/C Wall/Win. Tons Fan Paint Booth Outlet, Wall Service, Temporary Ductwork, Cost of A/C Central 4 -7 Ton Periodic Inspections Fire Pump Barbecue Outlet, Switch Process/Pressure Piping Signs A/C Central 8 -15 Ton Fireplaces, Number of Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv, Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Q'117. TYPE QTY. TYPE QTY. TYPL Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons TYPE Drains, Roof Cooling Tower T VTPE Miscellaneous Fixture Heating Strips, each Vent Hood, Cost Bath Tab 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 PLUMBING TYPE A/C Condensate Q-1-Y. TYPE Drains, Roof QTY. T VTPE Miscellaneous Fixture Soakage Pit Bath Tab Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply RECEIVED AND REVIEWED BY DATE: Page 4 PERMIT APPLICATION OFFICE USE ONLY ❑ OWNER -BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS I DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ 0/0" ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) Metropolitan Dade County (C.C.F.) $ 1 (sq.ft. = x/1000 x 0.60) Inspector State Educational Fund $ (0.005/sq.ft.) State DCA (Radon) $ (¢.01isq.ft.) Code Enforcement Fine $ Zoning Review $ Notary C $ �J 0 6 / TOTAL $ (� x ISSUING OFFICIAL REVIEWED AND PREPARED BY DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com c a MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT s Permit Date- - rr. ----- - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub ed 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 - - - - -- _ _- Employing Plumber's Name --- ) ---- - - — - - - -- -- No------ - - - - -- - - - -- ------------- Street------------- — -- ------ — --- — - Location and Legal Description Lot ------ - _ ___ -_ -__ __ �_ +Block _ ------ Subdivision Street and Number where work is to be Street ------------------ -------------------------------- State work to be performed and purpose of building (By Floors) -------------------------- - -- - -- - -- ------- - - - - - -- - -- -------------------- --- - - - - -- -------- --- --- --- - -------------- New Building - - - - -- ---------- Remodeling„ -- - - - - -- ---- - -_ - -- Addition- ------ - - - - ------------ Repairs------- - ----------------- No. of Stories -------------------------- Size Septic Tank Type of Tank ---------------------------- -- - - - - -- - Capacity Gals.----- - { Feet of Drain Tile--- -- - - - - -- - - - -- - - -- ------ -- -- -- -Dist. Feet of Tank or Drain Field from WelL ------ — ------------------- - -- _ - _ —__ -- ------- _-- --- _— _-- _ -_ -_- - Nature of Water Supply City Well.___ - - - - -_— _ -__ -- -- -Size of Soakage Pit __ - -_ __ -_ -_ -- -- - __ -- -- --- ------ -- _��--- _______� -- -- - - -- -- - r T 19 Amount of Permit $�'� : --- - -- -- -- -------- ----- - - - - —_ — (Signed) Iderstands -- --- -- -- - - - - -- - - -- --- - -- --- ---- -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he and accepts his obli ons 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 lundersigned agrees to employ only such sub - contractors, on -work to be performed under permit, are licensed by Miami Shores Village. - r, y 0 ( Signed )aF — l Master Plum 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 tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ___ -____ &-j — __ _ ___ ____ - -_ - -_ ___- -_ ___ -_-___ 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. -- ----------------- -- - --- -- - - - --- - --X-; — - ---- -- - - - - — -- -- - — — - — - -- -- _ - - — --------- - - - - -- - -- M -- Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BATH - :LAVA- SLOP LAUNDRY CATCH FLOOR DRINKINGJ�KN' ,�► TOTAL CLOSETS :TUBS SHQWERS ,TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS. - FIXTURES CONTR. LIST ' /.. CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G1. TANK CONN. FIELD PIT TRAP HEATER WELL - SYSTEM POOL q4 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 __ - -_ __ -_ -_ -- -- - __ -- -- --- ------ -- _��--- _______� -- -- - - -- -- - r T 19 Amount of Permit $�'� : --- - -- -- -- -------- ----- - - - - —_ — (Signed) Iderstands -- --- -- -- - - - - -- - - -- --- - -- --- ---- -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he and accepts his obli ons 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 lundersigned agrees to employ only such sub - contractors, on -work to be performed under permit, are licensed by Miami Shores Village. - r, y 0 ( Signed )aF — l Master Plum 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 tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ___ -____ &-j — __ _ ___ ____ - -_ - -_ ___- -_ ___ -_-___ 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. -- ----------------- -- - --- -- - - - --- - --X-; — - ---- -- - - - - — -- -- - — — - — - -- -- _ - - — --------- - - - - -- - -- M -- 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 PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING. PERMIT Permit No. -_D ___ 2 Date - -Z -a / R -_ -- Application is hereby L-f-or 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 Engine -- - - - - -- -- - -- — -- ---- - - -- - -- -- - - - - -- -- - -- - -- ---------- - - -- -- -- - - - - - -- - -- - -- - - - - -- -- - - - ---------- - - Employing Plumber's Name - - - - - -- - - ---- ----------- - --- -- Street -- - -- ----- - -- - -- - - - - -- - - - -- - Location and Legal Description Subdivision- Street and Number where work is to be performed —No.. �d �_,_t� Street - ______ _ -- - - - - - -- j..c._ State work to be performed and purpose of building (By Floors) ----- - - - -__ ___ -- ___ —__ _4r_!�� - - -_ ----------- - - - - -- -- ------- ---- - ------------------- _ ---------- New Building --------- yr -- ----/ ------------ Remodeling __ - - - - -- --- - - - - --__ Addition ---------- -- - - - - -- --- Repairs -------------------------- No. of Stories- --------------------- Size Septic Tank ----------------------- - -------- -- -- - Tyne 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___ _ -__ _- __- _ - - - -__ - _ - --- - - - - -- -- - -- - - -- - -- - -- - --- - -- -------- Amount of Permit $ -�r_ Q_ - - - - — ( Signed) -- - — - — --- ""'" --- - - -- -- - Plumbing Inspector.... The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)— - — '�!''1 - - - Mast Plumber:.... STATE OF FLORIDA, 1 J 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. ma# / BATH -LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL.. .CLOSETS TUBS SHOWERS .TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS FIXTURES CONTR. - i15T CHECK' SEPTIC SEWER DRAIN SOAKAGE GREASE. `SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL - CONTR. LIST` ,. CHECK" Size Septic Tank ----------------------- - -------- -- -- - Tyne 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___ _ -__ _- __- _ - - - -__ - _ - --- - - - - -- -- - -- - - -- - -- - -- - --- - -- -------- Amount of Permit $ -�r_ Q_ - - - - — ( Signed) -- - — - — --- ""'" --- - - -- -- - Plumbing Inspector.... The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)— - — '�!''1 - - - Mast Plumber:.... STATE OF FLORIDA, 1 J 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. ma# / L . t n MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No._1J _ o Date -S�►� s -Sf'�- -- Application is hereby made for the approval of the detailed statement of the plans and specifications h r e with submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division g gu g of Miami Shores Village shall be complied with, whether herein specified or not. A' copy of approved plans and -specifications must be kept at building during progress of work. Owner's Name and Addresst nig -- -Roof ng --- j%_* -------------------------------------- No. -_ -430 -- - - -- - - - - - -- - - - -- Street __N _ 79 -3t� -• _ _$di 8t�`I Registered Architect and /or Engineer - -- - - -- - --- -- - - - --- -- - - - - -- - - -- - -- --- --- -- -- - - -- - - - -- - - - - - -- - -------------- - -- - - - - - --- - -- - - -- --- - - - - -- Employing Plumber's Name _ - GiffAS21-- f?Q_Qf_i23x__%o --------- — ----- - ----------- - No._- _?„_Qa. DX --- 6Z-3 �tre�Ql�"5�2��1�_� Location and Legal Description Lot --------------- - ---------- - ------------- ------ - - - - -- Block - - -- --- - - - - -- --- - - - - -- -- - - - - -- Subdivision _------ _ ----- Street and Number where work is to be performed —No.. g9 - - - -. . -- ---------- _ - - -------------- Street --- X•�+_�'_ ------ 103. St State work to be performed and purpose of building (By Floors) ---- .----------- __ -- New Building ------------------------------------ Remodeling g -- ------------------- - ----------- 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 -- --- -__ __ - - -- - -- - - - - ----------------------- - - - -- - - --- - - - - -- - - Amount of Permit $ ------ jAb --- - ` ---- 393_.- ____Fee --- ©� - ( Signed) - - - - -- - - - -- -- - -- - -- — Plumbing Inspector.. The undersigned applicant for this building permit does hereby certify that he erstands and accepts his ob ' ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public' notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on ltckCn d under this permit, as are licensed by Miami Shores Village. G IFP'EN PANY (Signed - Master- pimubm- STATE OF FLORIDA, SAC dent ss. OU Y F DAD C NT O E Bef ore me, the undersigned authority, a n otary public, duly authorized to administer oledgments, personally appeared - - -- - - - -- - - - -- - - - - _- -- - S -' - -C •- _R -avmon ----- - - - - -- 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 CONTR. - LIST CHECK. SEPTIC SEWER DRAIN ' SOAKAGE GREASE: SOLAR DEEP SPRKLR. SWIM'G TANK. CONN. 'FIELD PIT TRAP:. 'HEATER WELL SYSTEM' POOL CONTR. - LIST:. CHECK Size Septic Tank - - -- --- - - - - -- -- - -- -- -- - - - --- -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 -- --- -__ __ - - -- - -- - - - - ----------------------- - - - -- - - --- - - - - -- - - Amount of Permit $ ------ jAb --- - ` ---- 393_.- ____Fee --- ©� - ( Signed) - - - - -- - - - -- -- - -- - -- — Plumbing Inspector.. The undersigned applicant for this building permit does hereby certify that he erstands and accepts his ob ' ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public' notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on ltckCn d under this permit, as are licensed by Miami Shores Village. G IFP'EN PANY (Signed - Master- pimubm- STATE OF FLORIDA, SAC dent ss. OU Y F DAD C NT O E Bef ore me, the undersigned authority, a n otary public, duly authorized to administer oledgments, personally appeared - - -- - - - -- - - - -- - - - - _- -- - S -' - -C •- _R -avmon ----- - - - - -- 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 PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. - [ate �' '�"'K— 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. ,p ,q� ,�[ Owner's Name and Address--- jf_J__l_lCi, ____ - f- - - -_1✓ C-------------- No._1______ __e -_ <_ __ Street l 6->--______�r__ Registered Architect and /or Engineer - --------- - - -- .. . - -- ¢, - - - - - -- - - - - -- - - - - - - -- -------------------- -- - - --- - - - - -- - Employing Plumber's Name- - - - - -- ------ - - - - -- � 1 YC S.. — ------------ No. - ------ --- - - - - -- -- - - - - -- Street -- - -- - -- — -- — - - - — Location and Legal Description Lot --- -- _ - --- _ ____- __ - -_- Block _ Subdivision--------- Street and Number where work is to be performed—No ------ ------ Stret--- _ _- )y"Z11_ State work to be performed and purpose of building (By Floors) ` =C - -� - -- - - e New Building-- - - --1. - -- - Remodeling - -_- _ -- -- -- ---- - - - - -- Addition------- _ - - - -- --------- Repairs -------------------------- No. of Stories - ------------------- - BATH LAVA Size Septic Tank __ / - -Type of Tank -- - -- ---- -- - -- Lea ----- - Capacity Gals -/�C� Feet of Drain Tile- - - - - -- 60 - - - - - -- Dist. Feet of Tank or Drain Field from Well- ------ - --------- ---------- Nature of Water Suppl it Well --------- - -- -- - - - --- -- ------ - -- --- - -- -Size of Soakage P• -- - --- - -- - - - - - -- - - - -- ------ - ----- --- - --------------------------------- — - -- - - -- - - - Si ed - - - - - - - -' '___Y - -_ -_ Q sp Plumb Inspector. Amount of Permit $ - - - - -- -- - - -° - - -� - --- -- - - ---.. � � ) - - - - -- - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an emp dyer of labor under the Florida Workmen's Compensation Act, being Section -5966, Compiled General Laws of Florida Permanent Supplement, a d has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the "work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforned under . this permit, as are licensed by Miami Shores Village. r ( Signed) - -! -- — - - �- Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly*sworn, upon oath deposes and says that he is the -------------------------- _ ------- ------------------------------- _ ________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. r — -- - - - -_ - - - - — __— _ - —_ -- -- - -- -- - - -- - - - -- - - -- -- - — -_ _ My Commission Expires Notary Public, State of Florida NOTE: A re4nspection 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. •- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TU85- SHOWERS °TORIES SINKS' SINKS TUBS URINALS BASIN DRAIN FOUN•T'NS FIXTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G TANK CONN. _ FIELD ..PIT TRAP - HEATER WELL SYSTEM POOL CONTR. LIST CHECK Size Septic Tank __ / - -Type of Tank -- - -- ---- -- - -- Lea ----- - Capacity Gals -/�C� Feet of Drain Tile- - - - - -- 60 - - - - - -- Dist. Feet of Tank or Drain Field from Well- ------ - --------- ---------- Nature of Water Suppl it Well --------- - -- -- - - - --- -- ------ - -- --- - -- -Size of Soakage P• -- - --- - -- - - - - - -- - - - -- ------ - ----- --- - --------------------------------- — - -- - - -- - - - Si ed - - - - - - - -' '___Y - -_ -_ Q sp Plumb Inspector. Amount of Permit $ - - - - -- -- - - -° - - -� - --- -- - - ---.. � � ) - - - - -- - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an emp dyer of labor under the Florida Workmen's Compensation Act, being Section -5966, Compiled General Laws of Florida Permanent Supplement, a d has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the "work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforned under . this permit, as are licensed by Miami Shores Village. r ( Signed) - -! -- — - - �- Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly*sworn, upon oath deposes and says that he is the -------------------------- _ ------- ------------------------------- _ ________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. r — -- - - - -_ - - - - — __— _ - —_ -- -- - -- -- - - -- - - - -- - - -- -- - — -_ _ My Commission Expires Notary Public, State of Florida NOTE: A re4nspection 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. muu ✓ 1 Sw.4 AF Ltw 91 '• Ti'i5..» .l..�w. $2'1p'.T ;.N,o NjEW&VA�Wr_ Mummom Sw.4 AF Ltw 91 '• Ti'i5..» .l..�w. $2'1p'.T PERMIT, APPLICATION FOR MIAMI: MHO MLA E PERMIT APPLICATION FOR MIAMI MQ I / MIAMI SHORES VILLAGE PLUMBING - ,INSPECTION DEPARTMENT APPLICATION, FOR PLUMBING PERMIT Permit Date - —2 —� - — 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 En neer - -_ - -_ _ - - - -- -- - -- . r Employing Plumber's Name------- -- _ - -_ -- -- -- _ --__ -- __ - ----- -- - - -____ No --------- -- ------ ____ -- Street -- - - »_ _�__ ___ -_ - - - - - -- - r - - - -- Location and Legal Descrip o Lot-- -- - --- --- - - - --- - - - -- -- ----- -- - _ _ - - - - -- Subdivision — Street and Number where work is to be performed No._ Street -___ _______ -_ _______ -- __________- _____�_ State work to be performed and purpose of building (By Floors) - _ - - - - -- —_ -___ -� -- - -- �!' �! - - --------- - -__ -- -_- - ------ - - - - -__ ------------- New Building ----------- -- _ ------------------- Remodeling -- ---- - - - -- ---- - - - - -- Addition-- - - - - -- - -- - - - - -- -- Repairs -------------------------- - No. of Stories -- - - - - - -- --- -_ - - -- Size Septic Tank - - - - -- --- - - - - -- - - -- - -- ---- - - - - -- -Type of Tank - -- -- - - - - -- -------- - - - - -- ------------_----.Capacity Gals. - - - - -- - -- - - - - -- --- - - - - -- Feet of Drain Tile--- ___ -_ -- - ___ -- - -; - -- _.___Dist Feet of Tank or Drain Field from Well----- - - - -__ ----- _--- ___ - -- --- __ -_ -- --- - - - -__ ---- — ----- ___ Nature of Water Supply: City- Well ----------- - _ - - -- -- --- A_-- _. — ----- -_----- Size of Soakage Pit--------------- --------- - --- -_ - - -- ----------- --- - - -- -- -- - - -- - - -- ------------------------------- _ --------- — ------------------ - y - - - --- Amount of Permit' $- - --/A- 6-0.1 - - -- - - -- - -- - . ( Signe?neral - - - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that rstands and accepts his obliga s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Laws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under , this rmit, as are licensed'by Miami Shores Village. (Signed) ................. - - - - - - -- -- - - - ------ - -------------------- - ast 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. BATH LAVA- SLOP LAUNDRY CATCH' FLOOR DRINKING TOTAL - CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS IfRINALB BASIN DRAIN FOUNT'NS FIXTURES CONTR., LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE. SOLAR DEEP SPRKLR. SWIM'G TANK 'CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL' CONTR.. LIST... CHECK Size Septic Tank - - - - -- --- - - - - -- - - -- - -- ---- - - - - -- -Type of Tank - -- -- - - - - -- -------- - - - - -- ------------_----.Capacity Gals. - - - - -- - -- - - - - -- --- - - - - -- Feet of Drain Tile--- ___ -_ -- - ___ -- - -; - -- _.___Dist Feet of Tank or Drain Field from Well----- - - - -__ ----- _--- ___ - -- --- __ -_ -- --- - - - -__ ---- — ----- ___ Nature of Water Supply: City- Well ----------- - _ - - -- -- --- A_-- _. — ----- -_----- Size of Soakage Pit--------------- --------- - --- -_ - - -- ----------- --- - - -- -- -- - - -- - - -- ------------------------------- _ --------- — ------------------ - y - - - --- Amount of Permit' $- - --/A- 6-0.1 - - -- - - -- - -- - . ( Signe?neral - - - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that rstands and accepts his obliga s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Laws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under , this rmit, as are licensed'by Miami Shores Village. (Signed) ................. - - - - - - -- -- - - - ------ - -------------------- - ast 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. f PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date &L y "Job Address Ff /v 6 103 —�r Tax Folio / ( a 1 3 (P Q Legal Description Historically Designated: Yes No er see / Tenant Master permit # j 4 Zi Owner's Address 99 N e /0,1 J r Phone ® 5-' Contracting Co. ZaZ1d/ Address 7s% Ql lvL /✓ ��Q° Qualifier --i/�` :�A1 ss# _ Phone 1,2 '�?. State # Y06 S 3 % Municipal # Competency #" / 6 yam' 9 ins. co. l Architect/Fngineer 6% Address Bonding Company eA Address Mortgagor ZIA Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL OOFIN PAVING FENCE SIGN .WORK DESCRIPTION// �) v Square Ft. S--/ , Estimated Cost (value) ''7' 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 re a n g construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.' 2m4A I Signature of owner and/or Condo President Date Sign atur C actor or Owner- Builder Date Notary s to Owner and/or Condo President Date Notary to Contractor or Owner - Builder Date My Commission Expires: My Commission Expires: E IALNOT R FAL OFRCIALN(7rARY EAL YNNE SACHI ER LYNNE RACHLER BLIC STATE OF VL0k- DA NOTARY PUBLIC $FATE C FC.ORNA SSION NO. CC592M COMMWION NO. CC59"�91Y1 MION EXP. OCT.13 2000 MY COMMISSION EXP. OCT -13 FEES: PERMIT Q RADON C.C.F. I _NOTARY BOND D� TOTAL DUE :y[ APPROVED: Zoning Buildin gf�w fg Electrical Mechanical Plumbing Engineering Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address N F_ 1 I City Mictmi &i��_Gtate Tenant/Lessee Name A JAN i 7 2006 L BY:__ -e-_ ----- -- Permit No. -4)) ��+ 10z Master Permit No. Electrical Plumbing M/echanical� -1 Roofing 1 l 1 �" 1, -� e, Phone # 61tm) ` _ A � 1 �}= Zip Phone # Job Address (where the work is being done) C City Miami Shores Villa ee County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address ' City M cam I Qualifier `°T', Architect/Engineer's Name (if applicable) State %'" d Phone # L_-3 o5) Is Q;) " L15-7R Phone # $ Value of Work For this Permit <:> Of Work: Type of Work: ❑Addition '[Alteration []New Repair/Replace �) r^ g ❑Demolition Describe Work:_ C f 1 ( 1'� ^� 1 CAA�[ •7 `.. Submittal Fee $ Permit Fee $ / - CCF $ 1.80 CO/CC Notary $ —' Training/Education Fee $ Zoo Technology Fee $ 3 !q `Q�, Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ Vl (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State 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 ins ection which occurs seven (7) days after the building permit is issued. the absence of ch posted notice, the inspection wi n t be approved and ' spection fee will be charged. Signature Si tore Owner or Agent Contracto The fore ing instrument was acknowledged before me this /57 The fore oing instrument was acknowledged before me thiVS7 day of , AY, by �'fi't!� /'j ✓e �-�Ql� day of G� —,20-0 by Get 7, c7 a/YPS who is rs wn to me or who has produced who is a y own to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOT IC: NOTARY PUBL Sign: Sign: AIVA AC ANA M. I VIUAXN AAJ& -MY Print: SSION # DD661830 CO Print: � 09, 2011 EXPHZPS: June 09, 201 My Commission Expires: ��NOTs' .RY Fi.NotwyDiscomtAsmCo. My Commission Exp r Y N State Certificate or Registration No. (Certificate of Competency Holder) Certificate of Competency No. *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 1,16166 Plans Examiner Engineer Zoning Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING P �t N FI - M " 1 -A PERMIT FBC 2004 ermt V. APPLICATION Master Permit No. ,1 3 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) PRI / /d& Phone # Owner's n /u Address Q9 E 10-3 5 's City MIAMI IIAM I 5HOP-f--S State FL Zip Tenant /Lessee Name E -MAIL: Job Address (where the work is being done) Phone # � - /5O -Z -t 0 City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company N / arne 0 ,%D, / Contractor's Address 4d ,0 tjW City i l Qualifier Name NO '/ 666c -felc �Nc, D S� Statej. Phone # 365— 758 Zip "33 /jr0 Phone # State Certificate or Registration No. �G �Q�}��9� Certificate of Competency No. E -MAIL: Architect /Engineer's Name (if applicable) Phone # 00 Value.of Work For this Permit $ �i ®� Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New �Re air /Re lace �,^^ /�,.�, p p El Demolition Describe Work: 2w 697P -S /ce Submittal Fee $ Permit Fee $ ®.dd CCF $ ,{ CO /CC Notary $ _ Training /Education Fee $ Technology Fee $ Scanning $ ' Bond $ Structural Review. $ Radon $ DPBR Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ (J -35 See Reverse side —)� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 i1zslag r Signatures li�i.✓' ��`°' '° Owner or Agent Contractor The fore ing instrument was acknowledged before me this,, The foregoing instrument was acknowledged before me this day of 20, by lam- L�J + � day of 20 "1, by'f" )�✓ // who is p onally known to me or wh roduced who is personally known to me or who h r uced As id take an oath. NOTARY PUBLIC: f)' Sign: Print: �N My Commission Expires: °fay APPLICATION APPROVED BY: (Revised 02 /08/06) as identification d \ean ath. N OTARY PUBLIC: _�• y ! A�' B C 1;�; a6 .off Sign: Print: �Iro My Commission Expires: . '1P °fd 9 Plans Examiner Engineer Zoning Zip :f fs 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 i1zslag r Signatures li�i.✓' ��`°' '° Owner or Agent Contractor The fore ing instrument was acknowledged before me this,, The foregoing instrument was acknowledged before me this day of 20, by lam- L�J + � day of 20 "1, by'f" )�✓ // who is p onally known to me or wh roduced who is personally known to me or who h r uced As id take an oath. NOTARY PUBLIC: f)' Sign: Print: �N My Commission Expires: °fay APPLICATION APPROVED BY: (Revised 02 /08/06) as identification d \ean ath. N OTARY PUBLIC: _�• y ! A�' B C 1;�; a6 .off Sign: Print: �Iro My Commission Expires: . '1P °fd 9 Plans Examiner Engineer Zoning