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�.° Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 11/04/2008 Inspector: Rodriguez, Jorge Owner: STERN, DAVID Job Address: 98103 Street NE Miami Shores, FL 33138- Project: <NONE> Contra -tor: AMADI ROOFING INC Buildina Department Comments Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number Parcel Number 1132060131570 Block: Lot: REPLACE TILE ROOF Inspector Comments Passed %r CREATED AS REINSPECTION FOR INSP- 98965. CREATED AS f/ REINSPECTION FOR INSP - 84156. NO LADDER OR PERMIT AT JOBSITE Failed El CANCELLED BY CONTRACTOR LEFT MESSAGE ON VM, 10/03/08 Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid Monday, November 3, 2008 Page 1 of 2 R Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 09/23/2008 Inspector: peetor, (IVv�fo Owner: STERN, DAVID Job Address: 98103 Street NE Miami Shores, FL 33138- Project: <NONE> Block: Contractor: AMADI ROOFING INC Building Deaartment Comments Permit Type: Roof Inspection Type: Work Classification: Roof - New �� Phone Number Parcel Number 1132060131570 Lot: REPLACE TILE ROOF Inspector Comments Passed please call (786)231 -8874 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Monday, September 22, 2008 Page 1 of 2 y Ji Inspection Date: 09/23/2008 Inspector: Inspector, Default Owner: STERN, DAVID Job Address: 98103 Street NE Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Project: <NONE> MGM Contractor: AMADI ROOFING INC Buildina Department Comments JGF,. Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1132060131570 Lot: REPLACE TILE ROOF 5104® Inspector Comments Passed please call (786)231 -8874 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Monday, September 22, 2008 Page 1 of 2 9 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 09/24/2008 Inspector: Rodriguez, Jorge Owner: STERN, DAVID Job Address: 98103 Street NE Miami Shores, FL 33138- Project: <NONE> Block: Contractor: AMADI ROOFING INC Buildina Department Comments Permit Type: Roof Inspection Type: Tin Cap Work Classification: Roof - New Phone Number Parcel Number Lot: 1132060131570 REPLACE TILE ROOF Passed Inspector Comments T7� b v Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, September 23, 2008 Page 2 of 2 Property Information Map Digital Orthophotography - 2007 0 ® 111 ft This map was created on 5/1212008 11:18:40 AM for reference purposes only. Web Site ® 2002 Miami -Dade County. All rights reserved. Summary Details: Folio No.: 1 -32 1 - ro NE 103 ST Mailing LORES PARENTE Address: INGLE FAMILY sJBaths: NE 103 ST MIAMI Fl�10 rs• HORES FL Units: 138 -2327 Property Information: rimary Zone: 1000 SINGLE FAMILY le Date: ESIDENCE LUC: 0001 RESIDENTIAL - $333,868 INGLE FAMILY sJBaths: 4 Fl�10 rs• essed Value: Units: 1 S Foota e: ,207 t Size: 11,910 SQ FT ear Built: 1953 IAMI SHORES SEC 1 D PB 10 -70 LOTS 1 & egal BLK 12 LOT SIZE escription: IRREGULAR OR 20851 11 2002 4 COC 2992 05 2005 1 Sale Information: le O/R: 2992 le Date: PM5 le Amount: 1$720,000 Assessment Information: ear: 2007 2006 nd Value: $407 229 20 uildin Value: $333,868 57,8 arket Value: $741,097 essed Value: $741097 otal Exem tions: $0 $0 le value: $741,097 http: / /gisims2 .miamidade.gov /myhomelprintmap. asp? mapurl= http: / /gisims2.miamidade.go... 5/12/2008 ra rp W4 1 my t. ll-),if,,�,, A - I a Owner's Notification Form IAM "Delivering Excellence Every Day" 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 an#Jhe 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. : a** 0080 e s G o e s Ln2. Renailing Wood Decks: When replacing roofing, the existing wood roof deco 0 have'lti be .... a * ..... renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricanc.Unes) of jig Florida* e. � Building Code. (The roof deck is usually concealed prior to removing the existing roof system). ' 0000 000000 . .. ..:..' [TZr3.Common Roofs: Common roofs are those which have no visible dehneatiolrbetWeen netiMbringe.... units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing'cein ractor and/or • owner sh Id notify the occupants of adjacent units of roofing work to be performed . s 90690 *sees '" .. . 0e a 080000 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof M WAg can $e 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 option of aintaining 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 roofings m is removed Ponding conditions should be corrected. 6. 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 the nda 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 Ownees/Agent's Signature: en Ritter Ca ital LC as 100: 1 4J I / / n Contractor's Signature: Permit Number: Property Address: L file!J//CVDoCuments" %.2oandMOs � F i etttngs/skylDeslctop/SECTiO1V 1524[1].htm9l2?l2007 5:46:06 AM - ROOF ASSEMBLIES AND lidO-FTO'STRUCTURES Florida Building Code Edition 2004 High-Velocity Hurricane Zone uniform Permit Application Form. Roof System Manufacturer: N Notice of Acceptance Number: Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): . I. P2: see P3: Maximum Desi _gn Pressure 006:90 •00 (From the Product Approval Specific System): 0000•• • 00000 0001 -0 *0004 Steep Sloped Roof Sygm Description *see* :00:0: 80:0 • 00 • • 0 0 0 ... 000000 Deck Type: I ii Roo Type Underlayment: _rw I Slope: I . 121 Insulation: Fire Barrier: Ridge Ventitatian? Fastener Type & Spacing: z5 q- c^4g6 Adhesive Type: Fastener r T Adhesive Type Cap Sheet: FMean Roof Height: Roof Covering: � --- - - - - -- _ -- ���u Type & Size Drip E 2�K 1, ji,4t4. Edge: (\ A7 15.34 FLORIDA BUILDING CODE — BUILDING ; 0 .... �►� Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL "+a Phone: (305)795 -2204 Fax: (305)756 -8972 �.� p �...:. Inspection Date: 11126/2008 Inspector: Bruhn, Norman Owner: STERN, DAVID Job Address: 98103 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: Building Department Comments Permit Type: Residential Construction Inspection Type: Re Occupancy Work Classification: Re- Occupancy QA-.� Phone Number Parcel Number 1132060131570 Block: Lot: Tuesday, November 25, 2008 Page 1 of 2 Inspector Comments Passed PLEASE CALL BEFORE GO ENESE WAITER 305.775.2798 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, November 25, 2008 Page 1 of 2 Parcel Owner Report Parcel Number: 1132060131570 Owner Information DAVID STERN Phone: 98103 Street NE Miami Shores FL 33138- Curren Owner: Yes 4 Tax ID: 1132060131570 Company: EMC MORTGAGE Related Permits Permit Number Application Date Expiration Date Status Imported Permit EL2004 -136 05/18/2004 06/23/2005 CLOSED Imported Permit BP2004 -610 05/06/2004 01/19/2005 CLOSED Imported Permit BP2004 -656 05/17/2004 06/16/2005 EXPIRED Residential Construction RC -11 -08 -2057 11/25/2008 05/25/2009 APPROVED Roof RF -5 -08 -859 05/09/2008 05/23/2009 CLOSED Roof RF -6 -08 -1130 06/19/2008 05/24/2009 CLOSED Tuesday, November 25, 2008 Page 1 of 1 iviia n oaui C5 V mage . Building Department 10050 N.E.2nd Avenue Miarni Shores, Florida 33138 �, � Tel: (305) 795 -2204 RE- OCCUPANCY it Fax: (305) 756 -8972 —�4�" �CA��ON � �� 2 2�0� l parmif W_ �1� x (��1 r n� D Y: - - - -__ Lo c ID Date J'V - Contact Name—, l'�".n �( ,j',� Phone# � :7 5" FY Buyer Seller Realtor .t/ Company Name ,mil Property Address q 10-3 .s KY- City Mami Shores State Fl Zip ,13 I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. `7 Applicant Nam Signature Aa O.S The foregoing instrume t was acknowledged before me this day of k& 20�� personally who is p ally known to me or who has produced VE) I as identification and who did take an oath. NOTARY PUBLIC. Sign: c$ Re -Occ. $60.00 Print: ti�c���`�•tioo yds. Notary $5.00_ My Commission Expires: CCF $0.60 '•s �� Total Building Officials Approval: �. (Rev. 10 102/03) Inspection Date: 11/13/2008 Inspector: Redriguez, Jorge Owner: STERN, DAVID Job Address: 98103 Street NE Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Project: <NONE> Contractor:. AMADI ROOFING INC Building Department Comments REPLACE TILE ROOF Block: oll�- N, Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number Lot: Inspector Comments Passed 0-To i2.rz-_ s . Failed Coir rection Needed I Re- Inspection Fee ($75) I No Add:f.cnal Inspections can be scheduled until re- inspection fee is paid. 1132060131570 Wedne.,day, November 12, 2008 Page 1 of 2 ` Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Projeet Address Parcel Number Applicant 98 NE 103 Street 1132060131570 Miami Shores, FL 33138- Block: Lot DOLORES PARENTE Owner Information Address Phone cell DOLORES PARENTE 98 NE 103 Street MIAMI SHORES FL 33138 -2327 Contractor(s) Phone Cell Phone OCEAN BLUE CONTRACTORS INC (305)234 -6065 Type of Work: Hurricane Mitigation Additional Info: Classification: Residential Fees Due Amount CCF $0.80 Education Surcharge $0.20 Permit Fee - Repairs $100.00 Scanning Fee $3.00 Technology Fee $2. 1 Total: $106.30 Valuation: $ 1,000.00 Total Sq Feet 0 Total Amt Paid I Amt Due $ 0.00 $ 0.00 Payment Type: (' n(j,, IJUN 2 0 PAID Available Inspections: Inspection Type: 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. June 19, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Thursday, June 19, 2008 1 1 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 3 Date -------------- �- -- , 19-- - - - - -- --------- - - - - - - -- -- -- -- -------------- Owner's Name and Address___ _ ____ t..-N- r- : -= - ------ -- - - -- No--- -- - - -- -- ------- - - - - -- Street-------------------------------------- Registered Architect and /or Eng er______ _o ' t - -- -- Name and address of licensed contractor --------- 6-L. � Location and legal description of lot to be built on: Lot-------- - - - - -1 - ------- -- - - - - -- Block--- -- - - - - - ---- -- - - - - -- Subdivi Street and Number where work is to be done_ ____ f State work to be done and purpose of building (by floors ------- ---------------- - - - - -- -- - -- and for no other purpose. --------- - - - - - - -- - -------------------------=---- -------- ------ -------- --- - - -- -- - -- - -- --------------- --- -- - - -- -- New Building --- .- ___--- ----- - -- - -- Remodeling-------------------- - - - - -- Addition---------------- -- ____ - - -- Repairs--------- -__------- - - - - - -- No. of Stories �L To be constructed of_C,____ ____ _____ _ Kind o foundation___ : __ __ _ _ __ Roof C erin --------- ______�___(__�___----------- ..� - „ C g Estimated Total cost of improvements $__ _ ___ e'_ �"'�___________________Amount of Permit $____ /�_- '_'_!! b -.___________________ _______________________________ r Zone cubage required_____ _ ___ ------- -------- - - - - -- -- - - - - - - -- __ _______ _________ _Plan Cubage ------- 3_[_ 7, O� - -- - -- - - - - -- - -- - - - - -- -- - - - -- -- ---------------- Distance to next nearest building----------------------------------------------------- - - - - -- -Size of Building Lot---------- --------- - - - - -- - - - -- -- ----------------------------------------------- Maximumlive load to be borne by each floor----------- --- -------------------- - - - - -- ----------------------------------------------------------------------------------------- ------- ------- ------ -- - - - - -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to-------------------------------------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar mpliance from all contracto�srsi,,t, b ontractors employed by him in the work to be performed under this permit; and will post or cause t be posted for inspe tion on e the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcopEr ctors, be perl6r � under this permit, as are licensed by Miami Shores Village. // Remarks--------------------------------------------------------------------------------------- - - - - -- ( Signed STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared----- - - - - -- ---------------------------------- ---- ----- - - - - - -- - ----------------------------- ----- ---- -- ------------- - - - - -- --------------- -------------------------------------------------------------------------------------------- ------- -------- - - - -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. �j Permit No ------- /_57a`Q_________ Date _______° i_"�____________- Read, Sworn to and Subscribed before me. Disapproved----------------- ----- ------ -- - - - - -- Date------------- ------- ------ ------- ----- - - - - -- ----------- ----- ------ -- ---- - - - - -- ----------------------------------------------------------------------- (Signed) ------------- -- - - - - -- - - -- -_ Id nsp Notary Public, State of Florida ector 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. CERTIFICATE OF INSURA CE � This is to certify that the policy or policiess, subject to the terms thereofs desig- nated below by number and providin6 the kind of insurance set forth opposite such numbers have been issued by the 'Company and are in force at this date. The insurance afforded is only with respect to such and so many of the kinds of insurance as are indicated by limits of liabilitys expiration dates and policy number, The name and address of insured the o erations and location of the operations � P , p rations to which the in- surance applies are set forth below. Name of insureds JORK PRAIF8 Address: 245 N* E. 87th Streets, Misid.s, Florida Operations: Carpentry - Masonry Dwelling Location of operations: Lots 1 & 2! Blk, 12, Sec, 11 N. 1. lot Ave* & 1603rd St• s Miami - S bores y norida • 1 Kind of- Insurance Limits of Liability Eiration. Polioy dumber Workments Com sation a As Compensation provided in applicable law 5/12/54 liQ 2538 and Employers' Liability One Accident Public Liability One Person $ 100 000 *00 (Bodily Injury) One Accident $ 300 =000.00 5/12/54 L 4153 Public Liability One Accident $ 19000.00 (Property Damage) Aggregate $ 109,00040 5/12/54 L 4153 Automobile Liability One Person $ (Bodily Injury) One Accident $ Automobile Liability- One Accident (Property Damage) Cargo Per Truck $ (Motor Transit), Aggregate (Each event) $ In the event of material change in or cancellation of such policy or policies the Company agrees to notify the party to whom this certificate is addressed of such cancellation or material change. Ten (10) days notice in writing mailed to or de- livered at the address of such party as herein stated shall be sufficient notice, DATED Nay 12s 1953 TO Town Clerk Village of Miami.. Shores ( Pa Miami S +s t Flori a B IIB ADDRESS By y arhorized7 e—nt i Y t ' ti F FFIDAVlT �3TATy of FLt3RMA COMM CF DATE j Dade ate, State of Florida* , cd' that i�9: c1f" that under t being, duly es7eorn, diorth r Ing proyisions of Ordinance Now 1850 dated Tub l Para$r4ph (d) of - 5e4tion 11-368 of Ordinancis Woo 97 of the 8 s yi # he desires to build-4 nLi, ? . e $ oa 0 1 and 2B1oc�k 12 of ion that he 18 the Omer of said p�iop y, and 31 be the Owner of said that he Id 11 do the k peronallyw l he i]le at such ties as are required by the Zrts IAS ara BuUdift 8; ieW j,, to File plans and specifications and obtain approval of the Planning, Board and the Building Inspector, 2, Apply for :and secure a Permit. 3e Fay the required fees. 4* Emcute the work in accordance with the provisions of this Go"* 5e Apply for inspections. • mile with the Building Inspeotor certificates that ptr has been made to carry the necessary Work cress Public Liability and Property Damage r r ?. File with the Building laspeotor as the job prey s< aerti. f icates showing the payment required by the Fedetxal Ua Security Act to the State of Florida or the United States of America. Be' Assume the responsibility of not mploying other than properly licensed contractors by Miami Shores Village for wW part or portion of the work. 9• Not Set himself up as a aeontriactortt. 1• Sign an affidavit before commencing work to the effeat that he has read this Article and will do the work peirasaeaalU and Observe all of the requirements; of the Buildingp Building S Plumbing and Zoning Codes of Miami Shores Villaoss of f4davit to be properly notarised upon blanks to be supplied by the Building 1aspector. lU Xn order to prevent abuses_ and subterf up the right of such cmnorabuilder as herein prov'idede ' is limited to bVA me riiilder Immilt each 2 years* and eta has once eaercized the privilege herein confors~ed no ssmad a=Ucation for omer- builder pamit shall be gwaftetIA ;tissts thin: 2 years, unless the applicant is guaalifiod as a lia"Ale d 06naral Contractor under the applicable 4rdi of Villagoo Azad Further this_ Deponent &&yss nott , U IBS i "T@ -DBE thhis: ��- r V44 NOS PUBLIG Notary Public, State of Florida at b My commission expires Sept. 1, 1955 1 d by American Surety Co. of N. X , DADE COUNTY LICENSE CC# D03583 BROWARD COUNTY LICENSE CC# 70- CSC -201X PALM 13EACH COUNTY LICENSE CC# 59077 MARTIN COUNTY LICENSE #00080 George Scott Obier State Licensed 305 - 392 -0641 GENERAL CONTRACTORS 1450 Northeast 123rd Street / ! North Miami, Florida 33161 }"C � /T ` /�% �'VO (305) 891 -8893 1 jo tj 1 -7a UL' J /0� c�Vl/4i(=/(- �f T J 2'ji" %,0, r��M �5- o To b. 0 V" irk��- ro 3 y`s . �� s . � �✓� vV a - Cif (!? . i � fg, C��� �e��a c2 CSC • l�e�M�T �r v� � e moat, T I N T 1A) ll %� �0 '(-"o I�'A ul . w� T(L�.cCC�SD� �� tie Sri ot/�� Gtlt � Dpr�cl � CL�C� W06 qlq'57-"3� f ow Glee! Cwm� 7 • o ej,',iQICA -L- (f)tz meo J)G41— u w , lie C'lfQ e /(4 O���� rL 16:AJ E.�4& CC MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PWMBING PERMIT Permit No. 1 J - Date - - - -- - - - - -- - -Co "g - - -- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted f 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address . ' Vii. .. %h!I�F_/ - - •--- - - - - -- No... __. r°!_...... - ----- Street _-_,'.`.:._�-_-21." ....... ..... � Registered Architect and /or Eng n __.. . __ - Employing Plumber's Nam ----- -- -- -- - - -•._ No._ »1_. .` -_ -_. _ » - - - - -- Strcet __ __ `_ x Location and Legal Description Lot - - -- _- _ - - -__ Block_ -- �%' _ _ Subdivision - - -` Street and Number where work is to be performed-No ----- - -__ - -__._ ..'-� �. »__ -.._ .___ Street __%� �` _-- •--- - - - -_Q ` '� ---- --------- - -- - -- State work to be performed and purpose of building (By Floors) --- ------------ - .- . -------------- ---------- ---- ---- . ------- ----------------------------- Remodelin Addition_____ Repairs- No. of Stories ew Building -_, - •--- - - - - -- - - -- - - -- - g - - - - -- - •-------- - - - - -- - -•- - _- ep Size Septic Tank = - - - - -- - - - - - -- - - - - -- -Type of Tank. ------ ------ - --------- - - - - -- --- - - -.__ _ ----- -Capacity Gals. - -- - - - - -- ------- - - - - -- Feet of Drain Tile -------- .-- - - - - - -- - __ ---------------- - -- Dist. Feet of Tank or Drain Field from Well ------- -- _.._-- .-- _---------------- ---.-.------------------------ ......, Nature of Water Su ly: City- ll.- - - - - -- - -- r - - - - -- -- - — Size of Soakage Pit -- .. - -- --------- - -- -- -------------------- ------------- --- - - - - -- -------- - - -- --------------- D - _ - _ _ - -- --------------- Amount of Permit $ —_ . — - ___ _ (signed) __ -------------- - - - -- ----- -------------- -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ;:1, 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 hike 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 noticee or noti as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be verfopAQ,, under this pern as art licensed by Miami Shores Village. -"_",� „ _/i � " -- STATE OF FLORIDA, l �. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath de oses and says that he is the _-- - - - - -- ----------- - - - - -- --------------- - - - - -- _ _. of the above described construction, that he has carefully read the Foregoing application, and that he did sign the same, and that all lac 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 Lail materials and /or anship. BATH LAVA SLOP LAUNDRY .CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SNOWHR6 TORIES SINKS SINKS TUBS l URINALS BASIN DRAIN FOUNT'NS FIETUREI CONTR. / LIST V / -- CHUCK SEPTIC SEWER DRAIN SOAKAGE GREASE D[[P SPRKLR. Swim G TANK CONN. FIIELD PIT TRAP NEATER WELL SYSTEM POOL ;,(J e. all, - CONTR. LIST CHECK ®o �� J' Size Septic Tank = - - - - -- - - - - - -- - - - - -- -Type of Tank. ------ ------ - --------- - - - - -- --- - - -.__ _ ----- -Capacity Gals. - -- - - - - -- ------- - - - - -- Feet of Drain Tile -------- .-- - - - - - -- - __ ---------------- - -- Dist. Feet of Tank or Drain Field from Well ------- -- _.._-- .-- _---------------- ---.-.------------------------ ......, Nature of Water Su ly: City- ll.- - - - - -- - -- r - - - - -- -- - — Size of Soakage Pit -- .. - -- --------- - -- -- -------------------- ------------- --- - - - - -- -------- - - -- --------------- D - _ - _ _ - -- --------------- Amount of Permit $ —_ . — - ___ _ (signed) __ -------------- - - - -- ----- -------------- -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ;:1, 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 hike 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 noticee or noti as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be verfopAQ,, under this pern as art licensed by Miami Shores Village. -"_",� „ _/i � " -- STATE OF FLORIDA, l �. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath de oses and says that he is the _-- - - - - -- ----------- - - - - -- --------------- - - - - -- _ _. of the above described construction, that he has carefully read the Foregoing application, and that he did sign the same, and that all lac 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 Lail materials and /or anship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. Date -- - -la -� S �� - - - -- 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address. - - - -- -- - - -, - - - __ - No._ - »._.. _ - Street ---------- - ---------- - - - --- -- - - - - -- Registered Architect and /or Engineers _ ---- -- ------------ _ --- ._ --- - -_ Employing Plumber's Name -------- --------------------------- -'t ___.. No ----- - ----- Street--.------. - Location and Legal Description Lot-.___._.--- _.- ------- Subdivision ------- _ --- »_ - -- ---- -------------------- Street and Number where work is to be performed-No --- ---- _..L».., .. Street ------- --------- - ------------------------------------------ State work to be performed and purpose of building (By Floors) _- ----------------- .» ----------- » ----------- ------- .---------- _. ---- __- .-- - - - - -. - _- - New Building_ • - -- -- - - - - -- -- Remodeling - - - - -- - - - - -- Addition.-------- - - - - -- ------ Repairs No. of Stories -------------------- - - Size Septic Tank AY-16A - - - - -- -Type of Tanis_.._ -___ -- .._. - _ _..._ .. _ pacaty als - ....... .. ... . - -_- Feet of Drain Tile --- -- -------- -- -- -- ------- - - - - -- -Dist. Feet of Tank or Drain from Well----- ...__. »__ _ ....- - - - -_. -------------- - - - - -. - -_.__ --- -. - - -- - - -- Nature of Water Supply: City -- Well -------- ---------- ------- - ------- - - - -- - - - -- - - -- Size of Soakage Pit__ - -- - ........ .......... . ---------- - - - - -- - - - - - -- ---- ------------ --- - - - - -- -- - -• -- - - - -- - -- -- --------------- ---- - - - - -- _ _ - _»._- Amount of Permit $-------- -- ' 4-''✓ - --- --------------- - - -, ( Signed )..- - - - - -- - - - - -- _ - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understan accepts his obligations as au employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be 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 tins p« rntit, as are licensed by Miami Shores Village. (Signed) w ------ -- __- _._...____ -__ -_ . -._ I ._.------ _ _. -- - - - - -- - Master Plumber. STATE OF FLORIDA, l �. COUNTY OF DADE. f Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 far therein by him stated are true. - - - -- - _— -- - - _._._... --------------------- - - - - -- - - - - - - -- My Commission Expires Notary Public, State of Florida NOTE. A - inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Lail materials and workmanship. BATH LAVA. SLOP LAUNDRY CATCH .FLOOR DRINKING. TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS Tuns URINALS BASIN DRAIN FOUNT'NS FIXTURtl 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 AY-16A - - - - -- -Type of Tanis_.._ -___ -- .._. - _ _..._ .. _ pacaty als - ....... .. ... . - -_- Feet of Drain Tile --- -- -------- -- -- -- ------- - - - - -- -Dist. Feet of Tank or Drain from Well----- ...__. »__ _ ....- - - - -_. -------------- - - - - -. - -_.__ --- -. - - -- - - -- Nature of Water Supply: City -- Well -------- ---------- ------- - ------- - - - -- - - - -- - - -- Size of Soakage Pit__ - -- - ........ .......... . ---------- - - - - -- - - - - - -- ---- ------------ --- - - - - -- -- - -• -- - - - -- - -- -- --------------- ---- - - - - -- _ _ - _»._- Amount of Permit $-------- -- ' 4-''✓ - --- --------------- - - -, ( Signed )..- - - - - -- - - - - -- _ - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understan accepts his obligations as au employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be 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 tins p« rntit, as are licensed by Miami Shores Village. (Signed) w ------ -- __- _._...____ -__ -_ . -._ I ._.------ _ _. -- - - - - -- - Master Plumber. STATE OF FLORIDA, l �. COUNTY OF DADE. f Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 far therein by him stated are true. - - - -- - _— -- - - _._._... --------------------- - - - - -- - - - - - - -- My Commission Expires Notary Public, State of Florida NOTE. A - inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Lail materials and workmanship. } MIAMI SNORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uinde for the approi•al of the detailed stalumenc ut me plans and specifications herewith submitted for the build in or other structure herein described. This application is made in compliance and conformity with the Building Urdinance of Miami Shores Village, I'lorida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at -building during progress of the work. O.vncr's Name and Address ._�..�. L C .. 2 ....................__ ..... ... ....... — ......................... _._ No.� ».L.. „ »...... Street N45' Registered Architect and /or Engineer .............. .................. ............................... ........ .. .. ••. • -• »- ••• ••TTSt S• ••TTT• •t,H •, t,TTtT! }„H!•tHTtHIClt!•St• ••. .. Name and address of licensed contr,Actor ............ � R ........ �. .o.. _ ... m i a m.L... Location and legal description of lot to be built on: Lot...... /1-11 ....................... Block ...14..................... Subdivision ....� x 4� _ ...... _» Street and Number where work is to be done ............. ..t0 ....... ._�.... ».�..� �_........ �.._...._ »._— ..... ».» �. —. »..� ..................__ Stato work to be done and purpose of building (by floors )�............_.............._ ............................... . __ .......... _..._........_.........._.._.. _ — _ .......... .......r .ti?.T► .?- ....... tc.�� ra c... _ .. »....... o ® v ........... .... _ ........ ........... ............. .............._......_........_ „...... „...__ ... » ....... .and for no other purpose. New Bui! dins ........................... Remodeling ........................ Addition .......................... Repairs .......................... No. of Stories ...... . .............. _ To be constructed of ......................... land of foundation ............................................................. _. Roof Covering ............... ....... ........... ... _..__ Estimated Total cost of improvements S ........ . ` ......................... ^mount of Permit 5. ........ _ .......... » » ................... _........ Zone cubage required..... ............................................................... -..-....Plan Cubage ....................... „ ....... .. ....... ........ .....» Distance -to next nearest building............... .... ........................_....._ .._.....Size of Building Lot ....................... ..... _ .......... _ ...... ..... ............. ___ Maximum live load to be borne by each floor .............................................................................................._.... ............................... ....................... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to .. ............................................ ............................... The undersigned applicant for this building permit does hereby certify that he understands and a epts his obligations as an riuployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ceneral of Florida, Permanent Sup dement, anti has complied .cith the provision,. thereof, and will require sintilar compliance from all contra rs r sub-co, act s employed by him in the work to be performed under this permit; and will post or cause to be posted for inspectoo t site of w su t public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon sict s, A'"k t rfo ed under this pennit, as are licensed by Miami Shores Village. t Retnarks..._ .................. _ ....................... _ .................... ._ ...... ------- (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 Ile 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.. . a_lL ................... Date.....��1:�� 1.. ' ........_._ Read, Sworn to and Subscribed before me. 8 Disapproved Date ..- ........ _.........— .._ .............. ................................... ................................ _._. �..— _... „.._ I'd _.. Notary Public, State of Florida (Si ........................... _ .................................................... Building Inspector My Commission Expires ....... . „._ „........� „......._ „�.._._. _.: PLANNING BOARD ...................... ..................... _.._ ...... DATE Chairman........ .................... _ ............................... .......... .................. Member ....... ......................... _._..„_....„........... . ».... „._ ....... _ ......... _ ... _ Merr.ber ................................ _ ............................... _.._ ..................... _._ Membcr ........ ...................... ................... ... ............. — _ ..................... _ Member.. .. ............................................... _ ..... ....... .... _..— .... _ ..... .. Member .... » ................ — .._. „ ........... __..„ ...._ _ ................ _ .... — .._._... Council Approved ................................................. ...........Date Disapproved ......_. _.._........ ........... ............................... ...........................Date NUT El: A c•h.,rgc of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the I'lannir.g, hoard. A rc- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. DOCAT(ON OF WINDOW: Ale, UN I7 -OWNER-- L) - - PA � j f' S 11 FRO[yT-- m MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date_ _ 28, 55 Pnai P i ......................................... ----- -..... 1119 -- - - - - -- Owner's Name and Address_. ------ --------------------- No ------- Street ....... TIT. ...._ N • '' • 103rd St. Registered Architect and /or Engineer... -- -------------------- -- ---- --- - - - --- ----------- --------- - -- - ----- - - - - -- --- - -- ----- -- --- -- - - -- Name and address of licensed contractor.___.__ Sheet_Met9l--- _SpCCl alty CompsnY.. X ,3 T%37' 7�c ,._, Miami Location and legal description of lot to be built on: Lot--- - - - - -- ---- -- --- --- •---------- - - - --- - --- Block ----------------------------------- Subdivision ---------------------- ----------------- -- - - -•-- ------------------------- Street and Number where work is to be done ...... .------ 8_._y _t.._ E ..103rd S tre e State work to be done and purpose of buildin g (by floors )- addition to r G Bidenc c roofina -- -- - -_ -__ s_ __ - :__:and for no other purpose. New Building ------------- _------- --------- Remodeling----------------- -------- Addition-- - - - - -2 -------------- Repairs-- --- - -. --- ..._._ -_- No. of Stories ...... I - -_ one To be constructed of_ .0 e.B t_!S 9t -____. Kind of foundation __.-•_______________________. -------- .-------------------------- Roof Covering ---------- ui Z t up Estimated Total cost of improvements $_J!R8 _!.9C --------------- __ ----------- Amount of Permit $ -------- 5_• 00 Zonecubage required ----- -•------------•------- ----- --- -- --•-- -------- - --• --- - --- --- ----- - -- --- -plan Cubage ------------------------------------------------------------------------ Distance to next nearest building ------------------------------------------------------------ Size of Building Lot ---------------------------------------------------------------------------------- Maximum live load to be home by each floor ------------------------------------------------------------------------------------------------------------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to------- - - - - -- -•-------------------•------------------------------------------------------------------- - -• - -- ----- - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Flori da Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks --------------------------------------------- -------------------------------------------- - -• - -- (signed) - -- SEEET METAL SPECIALTY CO. ---------------------------------------- - - - - -- -------- • - - - - -- STATE OF FLORIDA, i COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared----------------------------------- ------ ---- ..--- --------------------------------------------------- -------------------------------------------------------- - - ------------------ - - - - -- --------------------------- - - - - -- ---------------- - - - - -- ---------------------------------------- - - - -to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_________ _ ________ _------------------------------------------------ ....._... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.__----- •_ _ ______ ____ __ ______ Date_-- -__A.... � __. Read, Sworn to and Subscribed before me. Disapproved- - - - - -- ----- - - - - -- Date---- ------- - - - - -- ----------------- _ - - - - -- --------------------------------------------- ---------------- - - - - -- ----------------------------------------- Notary Public, State of Florida (Signed) -- ---------------------- - - - - -- - - -- - - -- Building Inspector My Commission Expires ------------------ _...................... - .......................... PLANNING BOARD----- - - - --- - -_------- - - - --- ---------- ----- -- •- - - - - - -DATE Chairman---- --- ---------- -- -- - -- Member -----------------•---------------------•----•----------••------•-•---•---------------------------- Member----------------- _- •- - - -• -- -----------------. ------------------------------------------------- Member -------------------------- Member.. ------ ..-----------------•--------•------------- •-- -------------- ------- - - -- -- - ---_- Member ----------------------------------------------------------•------ Council Approv- ed -------------------------------------------------------------------- -- ---- Date Disapproved -- ------ --- -- -- ----- - ------- ------ •- - - - - -- --- ---- ------ -..Date NU A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the P ning 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 12terials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the ap royal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. Timis application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of w Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Mia i Shores Vill a shall be complied with, wh er herein specified or noI 4j copy of approved plans and specifications must be kept a• b ilding duri rogress of the ork. -j t" Date G -• �... ......... ............ 19.6 o. / A Owners Name and Address. - -t .. �C .c No. 1 /Y,� Street- - - - -•/ G .•• - - -- -_ -- - - - - -- • X Y Registered Architect and /or U°ineer -• R -- --------- - - - -_- ..............._. _._ • - ... .._ ..............._..... Name and address of licensed contractor - - -( --- ! r - - - -- - - - - -- - - -• -- ----•------•----• ------------------- ••---- - - -... .._ - - - - -- ......................................... Location an gal description of lot to be built on: Lot...... -- ....... 14 Block ------ + --•-----• . .- -_.. Subdivision . -. -. -- .... - - ---I ---- -- - -• --• - -• - -- -- -----•----------------------- Street and umber where work is to be done__...1`�. State w k to do and purpose of building (by floors )..... and for no other purpose. New Building -- ..___.--- _-- .-- _- •....... Remodeling. ----------- A....... Addition ------- -- ----- - - - --- ---- Repairs ---- ---------- _-- ._ - -._ -- No. of Stories .......................... To be constructed of .................... - ....... Kind of foundation .................. --------------------------------------------- Roof Covering ................................. .....- •- - -• - -- L 1 G'C Estimated Total cost of improvements $ -------- AZ21,T• •- -_ --•- . -- ......Amount of Permit $ ------ -- "" ................ ...................... ......... Zone cubage required -------------------------------------------------------------------------------- Plan Cubage --- --- ----- -- -- ---- --- -- --- - -- Distance to next nearest building ------------------------------- ............................ Size of Building Lot .................................................................................. Maximum live load to be borne by each floor ................................. _........................................................................................................................... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to ------------------------ _----------------•----------------------------------------------- -- -- -• -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer Of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General ws of Florida, Permanent Supplenient, and has complied with the provisions thereof, and will require similar compliance from all contr prs or sub- contractors erupptoyed by him in the work to be performed under this permit; and will post or cause to be posted for inspectio the the work�sy�c'h public notice or notices as are required by the Act. The undersigned agrees to employ only such su�;pntracon av�o be performed under this permit, as are licensed by Miami Shores Village. ----- - - - - -- (Signed) - -- STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared----------- - --------- _ ---------------------------------------------------------------- -___ ........ ............................................................. —.................................................... ----------------------------------------------------------- --- -------- - ••- .- • - - - -- -- -------- _ ----------•-------------•------- •----- -------- - ---------- to me well known and who, bein by me first duly sworn, upon oath deposes and says that he is the - ______ _ ___ __ ____ _____ _______ ___ _ _ _ __ __ .................................... . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. _ l - - - - -- Date -- - -= --- u Permit No..____(,�'t._. �l_ _______ ! _ h _ _ �_____ Read, Sworn to and Subscribed before me. Disapproved Date f- Notary ublic, State of Florida (Signed) C.. 11 . - -�-� y 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept a building during progress of the work. Date. ---- -- ----- --- -•------- --- - -- - 19`1._ Owner's Name and Address.._ __XQ�-/.�(._.___- l_1-.�_, S--_.----------- .---- _-.--- ------- -- - - -- No. - - - -- - lJ._-- - - - - -- Street. i -L � - - -f - _ -5- Registered Architect and /or Engineer ------------ ..... _ --------------- -- ___ ------------- Name and address of licensed contractor .___!___112 ._- I!Y_!�_1 �s1 Location and legal description of lot to be built on; Lot----------------------------- -- ------- -- - --- Block -------- - - - - -- --- '- -- -- - - - -- Street and Number where work is to be State work to be don a d purpose of building (by floors "BN e f ;C- -- -- -- ---- - ----- ----- --------- - - - - -- - -- -- ---- -- - -- --• - -- -- - -_.-.- -------------------- ----------- ---- --- ---- ----- -- ------- - -- --- - ----- - - - - -- - -- --- ------ •------ - - -- -- --------- • - -. and for no other purpose. New Building ----------------- -- ------------- Remodeling _- . ----------------- -.... Addition ---------------- _-------- Repairs ---------- .--------------- No. of Stories -------------------------- To be constructed of-- -- ---- ------ - -- - -- - -- -- Kind of foundation. ------------------------------------- --- ------------ ---- - - - - -- Roof Covering- ------ ----- •-------- ----- --- --- - - - --- - - - - -- Estimated Total cost of improvements $--- --- ------------- ------- -------- ---- -- - - - - -- Amount of Permit $ --------- -------------------------- .---------------------------------------------- Zonecubage required --------- ------- •-- ---- -- - -• - -- - ------------ ° --• -• --•-•-• -•-- - -- - -- - - -- --Plan Cubage ----------------------- -- •• - --- •-- •--------- - - - - - -- -- •- •- -- --- - - - --- --------------- - -- Distance to next nearest building _--------------------------------------------------- • ------- Size of Building Lot .___.._____ __ ----------------------------------------------- ------------------- Maximum live load to be borne by each floor------- ••- ----- - - - - - -- - - - - --- ------ -- - - -- ----------- --- ------ - -- - -- ------------------------------------------- ---- --- ---- -- ----• - -- ------- - - - - -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to--------------------------------------------- - - - - -- --------- - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup}�lement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to performed under this permit, as are licensed by Miami Shores Village. Remarks------ ---------------- — -------------------- -- ------------------------------------ ........... (Signed) - -_,. ---- --------- `- STATE OF FLORIDA, COUNTY OF DADE, ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared-------------------------------- ------ -- ---- ----- ------- - -- - -- - - - -- -------- - --------- ---- ----- ---- - -- --- ------------ --- --•- -- ------- ---- -- -- - - - - -- - --------------- -- --------- •-------------- - - - - - -- ----------------------- -- ---- --- •--- --------- --- - - - --- ---------- me well known, and who, being by me first duly sworn, upon oatb deposes and says that he is the_ ----- .--------------------------------------- ___ ------ ---------------------------------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No---------------- --- --------------- -- --- - - - - -- Date --------------- _------ •-- _________- -------- Read, Sworn to and Subscribed before me. Disapproved ------ _--------------------------- _ ----- Date -_. (Signed) ----- --- ------------- --- - - - - -- -- --. --._._--------- --- Building Inspector ------------ - - - - -- ------ ----- - - - - -- ----------------------- ------------ -- ---- ----- - - -- -- -------------------- Notary Public, State of Florida My Commission Expires ------------------- PLANNING BOARD--.-.--. ------------ - -------------------------- - - - - -- -DATE Chairman•-- -- ----- -- ---------- --- - - - - -- Member ----- ----------- ----------- --- - - - - -- - --- -- ----- ------ - --- -- --------------------------------- Member--------------------------------------- ------------------------------------------------- Member --------_--------------------------------------------------------------------------------------- Member... ------- ----------------------------- --•-- •- -- ----- - - - - -- --- ----- -- ------ ---- •------ ---- --- Member ------ --- --- Council Approved ----------------------------------- .............. ---------------- - - - - -- -Date Disapproved _. --------- - - -- - - - - -- -Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No....... 1. �.S' .................. Date ....... ...I 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 ...... ..,' �� .....................:...... ....................N.......: ........ Street ...... ..s..: .................. Registered Architect and /or Engineer. ........ ............................... .................................................... ............................... Employing Electrician's ans Name......... 4 . E ........... ............................... ado.......... ............................... ..Street ..................... Location and Legal Description Lot ............ ................................ _ Block....... ............................... Subdivision.... /� ............. a ff Street and Number where work is to he performed State .... . k ... ;. a ........ ............................... Street........:. ............................... .......... State work to be performed and purpose of building (By Floors) ............... . ......................... .............................................. ............................... New Building ................................ Remodeling ................................ Addition .............................. Repairs ...................................... No. of Stories.................... Service Underground Size Feeders .............:. Conduit ................ Main Sw ............................... Am ........Main Fuses......... Amps ................... ..... Amps Typeof Installation -- Conduit ........................ Tubing........................ B. X, L.........................Metal Moulding ............... ».... ...... ........» ....................... ........... » ........................................... 010 ........................................ :............................................................ ........................... Amountof Permit $.......... . ................................... ............................... (Signed)......... .. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi bligations as as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- Mrs employed by him in the Work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act, The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. � r (Signed)........: ... ...........•••••.. ::: ..... Mast ter Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally aipeared........................................................................................................................................................................... ..............................: to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ........................................... ............................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................................... ............................... ............................................................................... ............................... My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REPRIG. ORON RANGE RANGE WATER W. NEAT. l!��ACt STRIP TOTAL OUTLETS OUTLETS RECE'P'T'f No. LAMPS OUTLET OUTLET OUTLET CONN. NEATER CONN. N�i1TER NEATER CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL Sri. CAS. TEMP. PERM. 0.1 HP 1.5 HP TRANS. CONTR. / LIST « r f CHECK Service Underground Size Feeders .............:. Conduit ................ Main Sw ............................... Am ........Main Fuses......... Amps ................... ..... Amps Typeof Installation -- Conduit ........................ Tubing........................ B. X, L.........................Metal Moulding ............... ».... ...... ........» ....................... ........... » ........................................... 010 ........................................ :............................................................ ........................... Amountof Permit $.......... . ................................... ............................... (Signed)......... .. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi bligations as as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- Mrs employed by him in the Work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act, The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. � r (Signed)........: ... ...........•••••.. ::: ..... Mast ter Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally aipeared........................................................................................................................................................................... ..............................: 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. 1 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building rdinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept a building during progress of the work. Date s- ' -Z , 19S.i Owner's Name and Address . d � --- --- - - -� -� A -I � • - -• --- _ -- ------------------------ No...- - S-- •• -• - - -- Street.._ _.._ ®t� .f21] $T. Registered Architect and /or Engineer._.PAW!! - - -._. A...... V?P - ------ - - - - -- - -------------•----------------------------- -• -- -- - -- - -- --- - - - - -- Name and address of Iicensed contractor - - - - -- �'vJ. --------------------------- -- ------------- .-------------------------------------------------- Location and legal description of lot to be built on: Lot - -- -' --- -- - - - - -- - - - - -- -- Block --- P- S-- ------- ----- - - - - -- Subdivision -- •- - -_ WN A-- --- -- - - -: prt ------- - -'r"s ` --- - --- -- --- - - -- -- Street and Number where work is to be done - -• -I- - - - - --t --'_ -• -- - i--- • - ----.-P State work to be done and purpose of building (by floors) .... AA !....._ . • - - - - -- -------------•------------------------------------------ - - - - -• ---------------- - - - -_- --- --------- ----------------------------------------------------------------------------------- . and for no other purpose. New Building ------------ . .......... . ..... Remodeling ----- I ........._ Addition._._ __...:_._..... __ Repairs __- - -_ - -_ . __. __-- ..____ No, of Stories .......................... To be constructed of..G -------------- Kind of + #ound on .... ------- -- -- -- ------ - - ---- Lo Covering _ ?.!._._.._.. ----------- ONE) Estimated Total cost of improvements $._: _ ----------- -. - _Amount of Permit $_ _7___ -------- --- --- ------ -_- _--- _._- ._ -___ ...__- ._- .._____ Zone cubage required------------------ - - - - -- -------------- - -- - -- •- •-- ---- -- -- - -•- - - --- -- - - -- -plan Cubage- Distance to next nearest building. ----------------------------------------------------------- Size of Building Lot - - -- 1___k ------ )(12P! I • ..... ................. . ... 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 be sent to- - --- ..- J'-°-- - IZA ------ T- - - - -- - - - -- -• -- - • - -- - The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida, Permanent Sup dement, and has complied with the provisions thereof, and will require similar compliance from all contr ors or su ontractors employe by him in the work to be performed under this permit; and will post or cause to be posted fo specti nth a he work such i>lic notice or notices as are required by the Act. The undersigned agrees to employ only such, ubc ntrac o wor be perfb under this permit, as are licensed by Miami Shores Village. Remarks----------------------------------------------------------- --------- ----- -- •--------- - - - - -- ( Signed)ti_ -_ ---- - - -• -- STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared-------------•----------------------•----------- •------------------ - - - - -- • --- - - - - -- ----------------- - - - - -- — - _ _ .._.-------------------------- ---------------------------------------------------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ ------------------------------------------- .------------------------------------- ._--------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. *� Permit ----------------------- Datet.Q__'----- - .... Read, Sworn to and Subscribed before me. Disapproved ate -..-.--- ______ -_.--------------------------- (Signed) - -1.=1- Notary Public, State of Florida ng ns ctor 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. Air MIAMI SL -iORES 1/ILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.... ...... // Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other 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 budding during progress of, work. Owner's Name and Address.. _ .. .... ..........:........f!_ __.._ _......... : ......................... No:_ .7- ..... Street .... (......... ,,.r � .._. Registered Architect and /or Engineer ............................ .. q..... ......:. Employing Electrician's Name. ............ .....Nol , �Street ........ Y' , Location and Legal Description Lot.... _._Z, . Block_ ..../ ' .. ...................... Subdivision_.. Street and Number where work is to be performed —No... ...F_. .............. _ ._... * ........ ... ............Street.. �_,4!`. ;.. State work to be performed and p purpose of building (By Floors)..._..,,.Gt�... /� is Nev# Building _...__..) . .................. Remodeling ................................ Addition .._......._....... _. .._..:_Repairs...................................... No. of Stories ...... 0 �........ ; � 11 Overh ._.Amps..._ Main Fuses....l.. Amps Service Site FeedersQ._._Conduit..c,._..Main Sw._._. ....... ..... . �� ........ Type of Installation — Conduit ............. ........... Tubing ....... X ............ B.X.L ......................... Metal Moulding..._.. ......... ................ .................................... ................•_.._...__...._ ........._.._... _ ....... ......_.._._..__.. ,. ............_.._ ......_....... ....... ......... ............ . .............................. Amount of Permit $ ......... �'�'� ............................................... (Signed) ........ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersign €d agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ............ .............................. ........ ....... ,i Master Electricfatt. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, not ry public, duly authorized to administer oaths and take acknowledgments, personally appeared .............. ......... ......... ............................... ...... ........ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ................................................................. ..... .. of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................... ........ .............. _.............__......_... ..._ .... My Commission EXpires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. , -SPACE STRIP TOTAL OUTLETS OUTLETS RacE,P•T,s No. LAMPS OUTLET - OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CONTR. LIST CHECK A, ENT. DIST. - SERVICE SERVICE MOTORS MOTORS NEON - RADIO. SW. CAB. TEMP. PERM. O -I HP ".t -S HP TRANS. CONTR. LIST CHECK � 11 Overh ._.Amps..._ Main Fuses....l.. Amps Service Site FeedersQ._._Conduit..c,._..Main Sw._._. ....... ..... . �� ........ Type of Installation — Conduit ............. ........... Tubing ....... X ............ B.X.L ......................... Metal Moulding..._.. ......... ................ .................................... ................•_.._...__...._ ........._.._... _ ....... ......_.._._..__.. ,. ............_.._ ......_....... ....... ......... ............ . .............................. Amount of Permit $ ......... �'�'� ............................................... (Signed) ........ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersign €d agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ............ .............................. ........ ....... ,i Master Electricfatt. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, not ry public, duly authorized to administer oaths and take acknowledgments, personally appeared .............. ......... ......... ............................... ...... ........ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ................................................................. ..... .. of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ............................................................... ........ .............. _.............__......_... ..._ .... My Commission EXpires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. "` ,� �T Y- �,t . • .,z � ... MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.-- /'�r --- ? 3-- -- Date ------- ---- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. ---------- ------ -__ No._ ----- - - - - -- Street ... ....... ...................... Registered Architect and /or Employing Plumber's Name - - - - -- � -_ Jam* .�� is - ...... - Location and Legal Description ...... Subdivision-- Subdi vision --- -- :-......... - - - -- Street and .Number where work is to be performed- No._.____� - , O Street -.. ---------------------------------------------------- State work to be performeil and purpose of building (ley Floors) ----_. ------ - --- ------_----- ---- - --------------------------------- ------------ ------------------------------- New Building---------------- - - -• -- - - - - - -- Remodeling-- -------- --__ Addition-__ - ------------- Repairs ----- -------------------- No. of Stories......- ......---- - - - - -- CLOSETS B ATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY URINALS Tula CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N6 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. Livr CHECK Size Septic Tank- •---------------- - - - - -- — -- - - - - - -- -Type of Tank ----- ------------------- --- --- ---------- - - -. -_ --- - - - - -- Capacity Gals. - - - - -- Feet of Drain Tfle---_.-- --------------- - ------- ---- -Mist. Feet of Tank or Drain Field from Wen ------------- - --------- - -------------- --- -------------- - ---- ------------- Nature of Water Supply: City- Well.--.-- ------------------ ----------- ____ -- -Size of Soakage Pit--------------------- - - - --- Amount of Permit $-- - - - - -" - - -- ec Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com. plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be poster)' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, I IL COUNTY OF DADE. -------- --- - - -- - - -- - - - -- -- - ----- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the __._._.------ ------------------- _- ......- ...........--....... .... _-- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. _._____ My Commission Expires y - -Notary Public, State of Florida ___ C __ ---- NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty materials and /or workmanship. N MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT r 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 her described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 5 -+ Date----------------- - - - -- - -- -- ---- ------- - - - - --- 3 - - - - - -- - - - -- Owner's Name and Address._ _ ___ _ _w§___ _ ___ _ ---------- _ _ __ - -____ No. � Street \ -_- Registered Architect and /or Eng neer -_.___ -- ---------- _ - - - - - - -- -- ---- -- - --- ' --- Name and address of licensed contractor_______!15 _ ` _ � -- _ . 1 _k - - ,cam C � Location and legal description of lot to be built on: Lot------------- -- -- --- ---------------- - - ---- Block-------- - - - - -- ----- ----- - - - - -- Subdivision-------------- - - - - -- -------------------------------------------------------------------------------------------- Street and Number where work is to - be done -- - - -- ------ -- --- --- - - �_C- _-S.-`Ir ' State - - ----- - - - - -- work to be done and purpose of building (by floors) --------------------------------------------------------------------------------------------------------------------------------------- -------------- ---- - - - - -- --------------- - - -- -- `--- - - - - --\ %, "0" =�-- �= C=- vN--, C-�CL_/ - - ------------------------------- ----------------- ---- -- --- - - - - -- ------ ------------------ ------------------------ ------ --- ------ -------- - - -- -- ------------------------- -------- --- ----- ----- - - - - -- -.and for no other purpose. New Building ----------------------------- Remodeling_- -- ------- ------- - - - - -- Addition -.- ---- ------------------ Repairs--- ---------- -- - - ---- No. of Stories_ ------ --- --- To be constructed of ---------------------------- Kind of foundation ---------------------------- Roof Covering ----------------- Estimated Total cost of improvements $_____ __- _tj_c____�""_.C�____________ � 0 ..__Amount of Permit $ --------- ----- 3'- '--- ------ --- - -- -- -- - --- • ----- --- -- - ------- - - - - -- Zonecubage required--------------------------------------------- --- ----- -------- --- ----- - - - - -- --Plan Cubage ------------------------------------------------------------------------------------------------ Distance to next nearest building ------------------------------------------------------------ Size of Building Lot-------------------- ----- ------ -------- -- ---- - - - -- ------------------------------- Maximum live load to be borne by each floor ----_--------------------------------------------- ---- ----- -------------- ______ -_ -- ------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may 's� ~— -+ J-� - -- -= -- ----_------------ be sent to-------- Ais3�s' - - -- °, --- - - - - -' The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site f the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subco tracto on wor to per � " nder this permit, as are licensed by Miami Shores Village. v_ -- 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. Permit No -------- --- __1________- __________ Date ------- `° - 3___ -____ Read, Sworn to and Subscribed before me Disapproved------ -- - --- - -- - - -- D e -- -- - -- ----------------- ---------- - - - - -- ------------------- ----- - - - - -- ----------------------------------------------------------------- L�� Notary Public, State of Florida ( Signed) - - -- -- - - Buildin g Ins ctor My Commission Expires_ ------ ---------------------------------------------- PLANNING BOARD -- -- - -- - -- - DATE Chairman--- - - - - -- -------------------------------------------------------------- -------------------- Member ------------------------ --- ----- ----------- - - - --- P Member----------------------------- - ---------------------------------- --------- - - - - -- Member ----- - - - - -- - - Member_. -------------------------------------------------------------------------- ---------- - -- - -- Member Council Approved ________________________ _ --------------------------------- --- 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. (,°I MIAMI SHORV VILLAGE BUILDING INSPECTI DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept a' building during progress of the work. Date_ -- --- 196 Owner's Name and Address. - - - - --` !1.%)_P/ f 1f J r -` - No.r ✓ Street /e 3 r -- - -- --- - --- ---- - - -- Registered Architect and /or Engineer- - Name and address of licensed contractor _____ /t /2"L, _ -- . -___c - /� -_ *" /Y_ Location and legal description of lot to be built on: Lot---------- -------------------- ---- - - - - --- Block- - -- - -- - -- - - -- --------- - - ---- Subdivision - ---------------------------- ----- ---- --- ---------- --- - - - - -- - - }i � f Street and Number where work is to be done _________,% _L'___1,___._ State work to be done and purpose of building (by floors) ---------------- _ - -- -- - --- : -------------- -- _' _ -- - y. ------------ ! -- - / - -•- �arz r/��' • STS - - - -- - -- ----------------------------------------------- and for no other purpose. New Building------- - - --- -- Remodeling ----- --- - - - - - -- - - - - -- Addition----------- --- --- - -- - -- Repairs -- -- - - --- ---- - - - - -- No. of Stories-------- ------- - - - --- To be constructed of_ _ _- _____- Kind of foundation__ ______ _________ ---- ------- .. ______ _ -_____ Roof Covering----------- --- _ Estimated Total cost of improvements $ ____ 1`2:", " ' - - - -- - -- --- - - - -- Amount of Permit $- - ----- - - - - -- --- -------- --- ------- - ----- --------------- --_..•_ -- Zonecubage required---------------- ----- --------------- -- ---- -- ------------- - -- - -- -plan Cubage ----------------------- • ------------------- ---------------- ---- --------- ---- --- ------- -- -- - - -• Distance to next nearest building --- ------------------------------------------------------- Size of Building Lot------------------------------------ ---- ---- ----------- - - - - -- --- - - - - -- Maximum live load to be borne by each floor------------------------ -- ------ ----- - - - - -- --------------------------- --- ---- --- ------ --- -- -- - - -- - I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b 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 suc pblic notice or notices as are required by the Act. The undersigned agrees to employ only such subc r: / c to/s / mo w',w t'o be performed under this permit, are licensed by Miami Shores Village. --- - --- -- ------- -- ------ -- -- - - - - -- e (Signed) - ! � ` STATE OF FLORIDA, COUNTY OF DADE. J ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared -- - - -- --------------- -- ---- - - - - -- --------------------------------------------------------- ------------- --- - - - - - -- -------------- --- ------ -- ----- -- --- - - - - -- ------------------------------------------------------- -------------- -- - -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 gqa,,re true. Permit No -------------- ______ Date____ _ ��_ ______ Read, Sworn to and Subscribed before me. Disapproved - - -- ----- --- - - - - -- a -- --- --- ---- -------- - -- - -- ----------------------------------------- -------------------------- - ---- Notary Public, State of Florida (Signed) - - - -- - -- -- - -- _ ----- -- --------- - - - - -- - - - - - -- - - -- - -- Buildin spector 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. - . MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the app royal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Q �7 Date .......... J-I UE----- -1 --�'__ 1.9.5-f .................. ,19 ........ Owner's Name and Address - - -- JDkiN-• .XAJ_ -F------------------------------------------------ - - - - - -- No ...... 9•s............ StreetA. F_..-- -••1 Q.3R.IJ - - - -S T • Registered Architect and /or Engineer- - - - -- ----------------------------------------------- ------- --------------------------.-.... .................................. ---•• .................. -.-- -_......... Name and address of licensed contractor ------ S- E.A_V -a.z. 181 ---- A.1 NT- N -G._,. 0- .------ -_____ ..... 9.T.a___5,.T.. ................ Location and legal description of lot to be built on: Lot ...... 1---- .& --- 2..................... Block ..-------- ...1.2................ subdivision ....... L4.&M- 1 ----- SkiQ.RE ---- E Street and Number where work is to be done ......... 9.8 .... N...--- -E- • ----- 1 Q 3 RQ S ........ ........................................................... ................... State work to be done and purpose of building (by floors) ---------------------------------------------------------------------- -------------•----- ---------- ................................. ...................... ................................. --------------._......- ------ - ------------------------------------------------------------------------------------ and for no other purpose. New Building ......................... ...... Remodeling .......................... Addition- _- _-X --------------- ._. Repairs ........ -.-- .--- _..._. -.-- No. of Stories ........................ To be constructed of M_E T A.L -____. Kind of foundation ----------------------------------- __ _________________.._ -__ � j RoStWovenng_.__...ALUMINUM - - - - - -- Estimated Total cost of improvements $ -------- 5.00..-..00 ......._.._.•__ -_ - .Amount of Pen.... $.._. -.-Y "- '- ...__.. -. Zone cubage required ----------------------------------------- -------------------------------------- Plan Cubage...... - - - -- ------------------•---------•-•--•---•----•••--•---- •-- -•- ---- -------- .._.... t l/ Distance to next nearest building .----------•-------------- •----- ...- __..-------- ..... -_ -- -Size of Building Lot .--- ••-- - - - -111 �- �---•---- X..... �- �. �-- �-- •--- •------ •---- _-------- - - - - -- Maximum live load to be home by each floor.. ------------------------------------------------------------- ------••----------•-------.....--•----------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to --------- — ......... -_------------•-•------•------------------•----------- -------- ---------------------------------------------------------------------- ••-- •-------- ••--- - -• - -• The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the 00 of the work ch public notice or notices as are required by the Act. The undersigned agrees to employ only ;Suchh. s ubc rs, on rk to be p+sif ed under this permit, as are Ifoensed by Miami Shores Village Remarks-------- - ----- - - - - -- ---- •--- •-------- •-- _ - -_ -- -- - - - - -- --------- . - - - -- ( Sign -- - - -- 'V- - - - - -- STATE OF FLORIDA, + COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ---------------- ••---------------------- - - - - -- .... ---_ ...... _ ------ •--- ------------ -------- - ---------------------------------------- - ---------- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ ----------- ______ ____________ __ .. _ _ _ - ....._...__.......__......___.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit _ _________________ Date_ - _l_T__. --� -Read, Sworn to and Subscribed before me. Disapproved ------------- --- --- - - - - -- - -- Da - - --- -- - - -- ----------------- -- •----- ••--------- - - - - -- -- - - - - -- -------- - - - - -- Notary Public, State of Florida ( Signed) .. - - - - -- .... a ..... ._..... - -- - - --- - - - - -• - --•- ui ng Inspe My Commission Expires ____- _____________.................... LANNING BOARD----- ----------- - - - - -- ---- - - - -•- ------- - - - - -- -.-DATE Chairman........................... ............................................................... • -- Member ---------------------------------- ---- ............................................................ Member-------------- -------.---..-- •--- --------------------------------- •-- - - - - -- Member Member......... ---- --------- ------------------------ ............................... _ ............ .. Member - •- ............... ----------------------------------.....-------•-----------•-•-•--.._...._.-•-- Council Approved. - -- - _------ ---- ---- -- - -- --- ------ -- ---- ••- -- ••- -•-- -•- •......... ..Date Disapproved _. ---------- ---------------------------------------------------- Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 4 _ jo r MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building rdinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date a m ...40p ..••......... ,19-- _..._. Owner's Name and Address.. - • -•- - No. - - - -- .. Street ._ ... - -- - i # T. Registered Architect and /or Engineer -- ------- - - - -- - - -• -- ---------- - - - - -- - -- - - -- .. -- .- ... ....... -----•-•-•--...---------•- Name and address of licensed contractor...... - Location and legal description of lot to be built on: _ Lot ------- . -__ -• __ ._. - -_ -_ Block-. ........... Subdivision__._ Street and Number where work is to be done. --------- -__ -- - - - -_ a, . State work`to be done and purpose of building (by floors). -- - - - - - -- __ _ _ _ _ __ - --------- __________________________ _ ____ __ _ _ __ __ _ ............. ............... _.---- -•.... .._._.- .. --- ••--- ..:: - - -- - `--------•----•-------------•-----•-------------------- •--- •--------------- - - - - -- -.and for no other purpose. New Building ............................ :. Remodeling._..,. .............. Addition- -- X------------ - - - -- Repairs -------------------------- No. of Stories ...... ............... To be constructed of- ..... Mr,Lj-t_... Kind of foundation . ... .... ......... ..._._:- ---------------- -._- - - -- Roof Covering-- .- _.- - -At -um INW---- -. - - -- Estimated Total cost of improvements $ ---------- " 00.11.00 ................... Amount of Permit $ ................................................................... ------ -- - - - --- Zone cubage required ------- ----•------------------ ----------- ----•- ----•-- -- - - - --- --- --- --- - -- --Plan Cubage ...................... ....... - Distance to next Lnearest building ----------------------------------- ....... . ............... Size of Building Lot. ............. 11 t-- - -5. -- .144-t ---------------------- _..._.. Maximum live load to be borne by each floor ................................................................................................. I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to ---------- - ---------- -•--•-- ------------------------------------------------ - -- ------------------------------ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks.-- _- ---- --- -- - - - -- --- --- _- ••-- _- --- -• -- ----- -- - - -- -- -------------------- - ---------- (Signed)... ....................................... STATE OF FLORIDA,+ COUNTY OF DADE. - � Sri �-•- .'�,� Before me, the undersigned authority, a notary public, duly authorized to admini, ster oaths and take acknowledgments, personally ap- peared-------- ------ •- -------- _ - - - - -- - -- -- -_ - -------------------------- ---- ---------- ---- -- --- -- - --- ------•------•---------• .................... - ........ ............................................... - - - -- ------------ - - ---------------- ----- •---- - - - - -- - ----------- - -• - -- ---------- - - - - -- • - - - - -- _ --------- 10 me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_----------------------------------------- - ...___........... .-- :. -_•- ..-- -._.._ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No ---------- - ------------ _ ----------------- .. Date -.- •------- ---- -- -- --- -- --- -- Read, Sworn to and Subscribed before me. Disapproved- -- - - -•.. Date- --- ----- ------ -- - - -- ------ ------ ------- ............................................ (Signed) ------------ - - - -•- -- - - - - -- - -- ...... 11 ---------- - - -- --------------- --- -------------- .. - Notary Public, State of Florida 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. JUNE 18, 195 JOHN PNAIFE 98 N. E. 103RD ST. MIAMI SHORF€'S, FLA i 1 i i } ,o Jo b iv cJ- MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 1, , ,/ Date_ ...- .- -_.. -- er's Name and Address._. `. R. :?.. .....,s 'f.1d 1.- _..... °.-.. _.: -• --- No.......„t.. Street- ....;.. 11kocation We,fed Afrltitt�;;l iti uNf, Enginrrf :_ e and address of licensed contractor ..... .a.•t ................................................. .. .............. and legal description of lot to be built on; Lot.. - Block j -------- Subdivision � f' c 1r----•--•--- ••- •- ......-- •- --......••... -- • -• - -- y Street and Number where work is to be done -- ......... ..._ --- ---------- _- L- - - -.'- �-- f:_- -- -._::_.._..--•----•--------•--.----- .__....__..__---- -------- --_.�_ State work to be uo „e and purpose of building (by floors) - --- -- --- •- •- •----- --- - - - - - -° c f - - r' - ft- -------- -_ - - -- ,� �= x` f � / /-------- ------- - - - - -- __ ... - ... __. ---- 1i- s :a- _--- - - - - -- - -:and for no other purpose. r New Building ----------------------------- Remodeling ------ -- ------ -- --- - - - - -- Addition-------------- Repairs .......................... No. of Stories. ....... ................ To be constructed of - - -- - - - - - -- -•- - -- Kind of foundation-------------------------------------------------- •- -- -- Roof Covering--- - - ---- --- - - - -- -- - ----- --- --- .,z 1 Estimated Total cos; of improvements $ ------------ tr ------ $ - , ..... .............. Amount of Permit $�- - --_ -_ -._--- - ----- -............................................. --__ - Zonecubage required -- ------ --------------- - - - - -- -------------- ---- -•--- ------- -- -- - - - - -- -flan Cubage ---------------------------------------- ....................................................... Distance to next nearest building -- -- - -•- - - --- - - --- ---------- ---- - - - --- -Size of Building Lot. ........................................ - ------ - --- - -- ---- -- •-- -- _ - ---- Maximum live load to be home by each floor - - -- - ----- --------------- --- -- - - - - - -- --- -- - --------------------------- ----- ------- --- ---------- -- - - -- --- -----------------------•-- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to ----------------------------------------- tom_ - _ 7 r G - -...e _ The under, l-ned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under lie Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks "if r s (Signed)_ c__. x. a� !>< :Es��_ _ .✓� r'_L, �L -- - - 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-------------------------------------------------- ---- --- --- --- - - - - -- ------------------------------------------------------------------------- A------------------------------------------------------------------------------------------ ----- -- ------------ --- - - - -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. Pemut No ------- _----- j __ _ ____ . ________ _______ Date ------ .__9 -__.. ------ ---------- Read, Sworn to and Subscribed before me. Disapproved . - - - - -- Date -- -- ---••- -- ........... ........... - - — r Notary Public State of Florida (Signed) - -fit ` ti /_mot _4kl �” 4M1� `` �} - ---- - - - - -- - - -- - -- Buil6ing Inspector 1r 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. 3 � ,2 V' r MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby uinde for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building (Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address ............................................... ...... ......... _ ....... I ................. _.... No. ............. _ .... ..... Street._ .................. Registered Architect and /or Engineer ...... ... ......... ...................... ............ ....... ....... ........!.......... .............................. Name and address of licensed contractor.. G��?Q!?vu/t �vU en U. 7 j, N. c ctt7u [ ............................ . _ .......... .. ..G.......... _._...._ ......._. Location and legal description of lot to be built on: Lot...................................... ---- . Block... ......- - - - - -. ................. Subdivision. .......... ........... Street and Number where work is to be done.. M_ .�,_.'...L _ �q2� St. State work to be done and purpose of building (by �oars �.�ll?f1Y.e,._4/ze. exj4 uc n.UV .;uz�_, Ae [.ace 4-cat aitea trwktf 4 p� but.i. Ct a aa_pi taa and �itave C, Uped . ..................... ..... -- ..Can... .................. anal red cerrtent shin Le f i Ce. _._..._ ............._ ........................................... _ ..... _ ............. and for no other purpose. New Buil ding Remodeling ... ...................... Addition .......... .._............ Repairs._..._! � ................ No. of Stories ...... ................ _ To be constructed of .......................... Kind of foundation ......................................... ...................... Roof Covering .. g ......... �i ...... ...... ........ ... _.. Estimated Total cost of improvements $ ..... F.t.�M- 00 ........................ Amount of Permit $ ..... /-1`. 00 ....._._........._._._..... .__................- -- _-- .._... Zone cubage required. ..... ............. ......... ..................... ..._•........_........Plan Cubage.----- ............ Distance to next nearest building --.----•----------------- - ----------------- - ........ _ ..... Size of Building Lot ...................... ._ ..... . ........... ...... ..... ........... .._ ........ _ Maximum live load to be borne by each floor -- - - -- ---------•-•---------------------.-..------------..........---•-------•--...-----...--------.........................._ _........_..................... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to.. -_ --------- - --- ---- _- -- - -- - -_ - -- --- •-- - -- --- ----------------- -------_-------_------- ---------------•- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the "Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Snptt)leuient, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors a loved 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 och public notice or notices as are required by the Act. The undersigned agrees to employ only such subcomtractors, on work, to be armed under this permit, as are licensed by Miami Shores Village. Remarks --- _..... (Signed) (—_..:L ..__ _. - - •'- STATE OF FLORIDA, 1 COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persorially ap- peared------------------------------------------------- ---- ------------ ---- -- - - -- ------ -- --- -- ------ ----- •-- --- ---- --- - - -- me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . -------------- ...................................................... ...- ......... ........ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No..-- .r1:.?_ ..............___ Read, Sworn to and Subscribed before me. ------- - - - -- Date - -.. Disapproved Date -.... - ...... — - .... . ... ......... ... _._..__.. _..._.. �t t �� 1 �� Notary Public, State of Florida (Signed) - -- • -••• -- .................................... Building Inspector My Commission Expires ....... - ................. ........_......._ PLANNING BOARD ...................... ..... ............... _.._......DATE Chairman.....- . ................ ----•--------•----•---•--••----- -••- •-- --•--- • . ................ Member Member-------------------------------- - ........... --- •-- ••------ --- ------ ••- -- -- --•- -- •- - -• - --- Member .................. ............. ... ............... _ ... _ .......... --- ................. _.._ Member..... .......................... .......................... - - - — ..... ........ Member .... - ................ ,.._._ .......... _ ..._....-- ................ _.... -- CouncilApproved. ................................................. _ ...................... Date Disapproved ...... - .................................................. . ......Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MiAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statc.m-nr ut me plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. j i� Date.. _....�� ....._.._.. _.._........ ... Ow•nei s Name and Address .......... 4d/5a.:.,�, CL . <' ...._ ... No.... �','�._.. Street_,. �..�.. - ..... .........._.................... .. r _..........._. Registered Architect and /or Ep.�ineer. -•-- ................. Vame and address of licensed contractor.., ..- .,;......% �: � ... ....�; .... ..._ ---- _ -------- _ _ Location and legal description of lot tc be built'on: Lot............. ............................... Flock... ............................... Subdivision ...................... .. ............. _.:_._ ......._ _....._._.:.... ....._. ................. _...... Street and Number where work is to be done .............l t _ __.._ %f _ ...... ............... .. . .............� _ State work to be done and purpose of building b floors f .1!... ...-.--._.-- ......_._ ................... ................. .._...... ..--...... ..................I — —. ........ - ....... . ............................ __...._.__ ................. - ............................. _ ............ - ..... .............. and for no other purpose. New Bui! ding .............................. Remodeling ......................... Addition ....................... ... Repairs ................ ...... ..... No. of Stories ...... To be constructed of ........................ .p . . ICin o o foundation ............................................................. _. Roof Covering ................. ,........_..... - ._._....._. Estimated Total cost of im improvements $.. t. ------------------------------------ Amount of Permit S._.._........................... __ ................ --- .._.._., Zone cubage required ...... ...........•------------------• •- -••-- •--- •- ..............• - -- --.Plan Cubage ............................................................. Distance to next nearest building. .... ...................................... _..__....___._.Size of Building Lot ...................... _ ..... ._ .......... _...... ___................_.._ -_ -._ Maximumlive load to be borne by each floor ... ... ........................... •.... --•••....__..............--••--•........_.._....._.....-••---.... ........----- -................. -- ---- - -. - - -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to - - -• -- .................................... -_..--•---- •---- ......._•--- .. ........... . The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup dement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. i1- Remarks... - .................. - ................................................ ...... (S igned).._. _......__........._.�.---._.._. STATE OF FLORIDA, 1 COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ---- - ---------- - -_ _. __ - ............... - ------- - ---------- - ------------------ _ ------ - - -_to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . ...................... ........................................................... ._ ...... - of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit - --------- .. Date._X.) ;q•-'-1-1.. •M...... -_._ Read, Sworn to and Subscribed before me. > Disapproved_ ..... Date . . .- ......._ _ --••--• ................. ..........................._..- . _..._.. j ��.� Notary Public, State of Florida (Signed) -- - -- . ..... - "" Building Inspector My Commission Expires ................. ............. ._ ....... . Chairman ......... ..... .......... Member.- .............................. ............ Member - - ................................... PLANNING BOARD ...................... .................... _.._ ...... DATE ....... Member ...... Member ..... ...... . Member ..... CouncilApproved. ---------------- ................................ .............. - ...... Date Disapproved -•---- . .............. ..................... .......... ...........................Date :TOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has heen obtained from the Planning hoard. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection at faulty materials and /or workmanship. �Y E 14 h S Z� MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores` Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy- of approved plans and specifications must be kept at building during progress of the work. , Date — November - -2.4 - - > 19 -r`-3 Owner's Name and Address --- XTr _& Mrs • John Pno if i - - -_ No ----- --- -------------- street - -_ -- -- ____ -- -------- ____ -- Registered Architect and /or Engineer --------------------------------- ------------------------ ._ Sheet Metal Specialty Company, 573 NOW- Name and address of licensed contractor - - - -- - - - - - - - -- - - -- - - - -- - -- Location and legal description of lot to be built on: Lot -- -1 _� and -2 -- - - - -- Block -- 12 - - subdivision-- - - - - -- -Miami Shores - Section -1- -- - - - -- - - - -- -- - - - - -- Street and Number where work is to be done-------- - - - --� — -. E :_ - -_a. 4 l �� t �e------------------ -� - - -- -- -� - - -- - - -- - -- - - - - - -- � State work to he done and purpose_ of building (by .floors)___________ro ofin g on new residence - - - - -- --- - - - - -- -- - - - - -- ------ - - - - -- - - -- --- - - - - -- --- - - - - -- - -------- - - - - -- --- - - - - -- — — - - _- _-- ------ -- ------- - - - ------- - - - -- - -- - - - - -- -------------- - - - - -- --- - - - - -- - - - -- ------------ - - - - - -- - - - -- -- - - - - - -- - -and for no other purpose. New Building------- ---- -- ----- - - - - -- Remodeling------ - - - --- -- -- - - - -- Addition-------------------------- Repairs__ --------------- ------ -- No. of Stories ------- ------- _----- To be constructed of- -------- - - - - -- Kind of foundation - _------- - ---------------------------------- - --- ------------- _ Roof Covering---------- _ ----- _ -------- --- ---- - ------- - Estimated Total cost of improvements $ _ -_ 1225- t- 00- ,___ -_ amount of Permit Zone cubage required-- - - - - -- -------- - ----------------- -- - - - - -- ----------- - - - - -- -_Plan Cubage - - - - -- --- - - - - -- --- -- Distance to next nearest building ------- -------- - -------- __ __-- - - - - -- - - - - -- -Size of Building Lot - ------------------ Maximum live load to be borne by each floor -------------------- ---------- ------------------------- - - -- -- - - - - - - - -- - - - - -- -- - - - - -- ----- --- - - - - -- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to - - - -- ----- ---- - - - - -- - -- - ---- - - - - -- --------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to he performed under this permit, as are licensed by Miami Shores Village. Remarks- - --- - -- --- - - - - -- - - - - -- -- -- - - - - -- ------------------ - - - - -- ( signed) ...... Sheea__Met l _S1��ee i� lt�r _C ®mpswny 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 ar true Permit No ____ - ------ Date- ______ - `?- --�' Read, Sworn to and Subscribed before me. Disapproved-- - - - - - -- ----- - -- - ?'g Dgte- -- -- - - - - ------------------------- _- - — - - — ----- — -- — — - - - _ -- - —_ - Notary Public, State of Florida (Signed) - - -- ------------ - - - - -- --- - - # ---------------------- ---- - - - - -- Bui I eetor 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. y Miami Shores Village Paint Color Approval and Agreement Date S/ li�)Gl Owner's Name ����� %�9 /�o� ;®f Phone #CJQS� 1� Owner's Addresses C State �� Zip Job Address (where the work is being done) 103 S,;" City _ Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO,_L-1� Contractor's Company Name (if applicable) Phone # All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap1drip Edge Soffit Flower Awnings Chimney Doors and door jams Garage doors Railings Fences / Decorative metal All brick (simulated or regular) Stucco bandin Any other stucco features Accessory Buildings Other . Attach Color Samples With Numbers 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. Signature, Owner or Agent Date l Q41 r' r r APPLICATION APPROVED BY: Date chc 6/18/03 P& Official Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/12/2004 Applicant: KNIGHT Owner: INVESTMENTS JOB ADDRESS: 98 NE 103 Contractor Local Phone: Parcel # 1132060131570 Building Permit Permit Number: BP2004 -610 Page 1 of 1 INVESTMENTS KNIGHT ST Contractor's Address: Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 1 & 2 BLK 12 LOT SIZE IRREGULAR OR Fees: Description Amount FEE2004 -4813 Building Painting Fee $60.00 FEE2004 -4814 CCF $0.60 FEE2004 -4815 Notary Fee $5.00 FEE2004 -4816 Training and Education Fee $0.20 FEE2004 -4817 Technology Fee $1.50 Total Fees: $67.30 Permit Status: APPLIED Permit Expiration: 11/2/2004 Construction Value: $1,000.00 Work: PAINT Signed: (INSPECTOR) Total Fees: $67.30 Total Receipts: $67.30 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: Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 216 /2002 Applicant: CLIFSTONIA Owner: BUTLER Contractor Local Phone: i� Building Permit Permit Number: BUTLER CLIFSTONIA Address: Cellular: Parcel # 1132060131570 Legal Description: Job Address: 98 NE 103 ST BP2002 -251 Page 1 of 1 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 1 & 2 BLK 12 LOT SIZE IRREGULAR OR Fees: Description Amount FEE2002 -735 Building Permit Application Fe$60.00 FEE2002 -736 CCF $0.60 FEE2002 -737 Notary Fee $5.00 Total Fees: $65.60 Permit Status: Approved Permit Expiration: 8/5/2002 Construction Value: $300.00 Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT) Total Fees: $65.60 Total Receipts: $0.00 If there is no permlt package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee Is- $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time If the work is not done in compliance with such ordinances or If the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: J.. MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: I -\ OWNERS NAME: PHONE: ADDRESS: O' ADDRESS OF SITE: CONTRACTOR & LICENSP(iflpplicablO COMPANY NAME: PHONE: All Elements on the site must be listed and indicate the color to be painted. Walls Fascia o :- Drip Cap/Drip Edge_<'ce_, -,cz,, -0.,.._, j e e--r- �c o Soffitz __;Roof Flower Bins r Shutters w Awnings Chimney �:��1�- y j -4, ��� -rr} y x Doors and door jam, z Garage Doors Zo Railings yZt�/.2f� 1 Decorative 'Metal " l All brick (simulated or regular) v �� Stucco Banding ? _ UUCY`' `' ,e' `"e" Any other stucco features PIV M Accessory Buildings �aL'� I" - %>> 1-,L, Other '0 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 I 4le' stated. F he e , the paint colors will be as per the attached f er Date Signature of Contractor Date g FENN V;GY Building Officie date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 �I i I"Pe Is Allcy Pole D ETAI L. spa 1 = 2o' X(z, -3� �t ' I I 1 I Pot i� I oti� i it i i1 i I� 4, J0, - �- I' Polo Mar 2, 1°Jb3 .�o�n Pnai'�e X4.0 ao S SO J0 9 S 7 6 S 4 3 M Ar 13 15 i6 17 15 "5 20 21 22 23 ii T40 D0 Se .. .. • • .. .. - $S t — -- �; 102 M O . SY � -- - ENGINEERS CERTIFICATE: f hereby certify that the Survey of the prouerty described hereon is true and correct to the best of my knowledge and belief as recently surveyed under my direction and that there Z"o ncroachmen unless shown or noted. Su yor No. i,6. State of Florida. AUGUST DE wihKLER 0,ilL Et -_ N— ? NORTH MIAMI, FLORIOA SURVEY EM LOTS 162 IbLOC K 1 Z M I A► M l S H o RES S,rac. 1 V t LLAC-m or- M IAM I SHORES,FLOMInA According to plat Hook I0... Page. A'. !...of the Put)lfc Records of Dade County, Fla. 2S1232 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mt. If the Mt values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Tile Calculattons Per RAS 127" (PI: /'Ir+x A"s /.i. _ Iyg 1 = Mrl ���! Product Approval Mt y / 0-1 pb9��.t� -' Prcx{uct Approval Mf (���` glP.��1er x A ) Mg: Ma �3 Product Approval Mf T , Method 2 "Simplified Tile Calculations Per Table Below" D".,,,i, A Un- of Rncieln- rturrl Fmtn Table Maw Product Approval Mr Mr required Moment Resistance* 0 • Mean Roof Height -11 15' 20' 25' • 30' • • • 40' • • Roof Slope H Job Site Roof Slope • • 990 • • 2:12 34.4 36.S 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37.4 • 39.80 Minimum Attachment Resistance F, Product Approval Required Uplift Resistance Fr Calculated 4:12 30.4 32.2 33.8 35.1 •' • • • 37.3• 8:12 28.4 30.1 31.6 00 32.8 a 0 34.9 000* 6:12 26.4 28.0 29A 30.5 � • 32.4 7:12 24.4 25.9 27.1 28.2 • • 30.E • • AALJ • *Must be used in conjunction with a list of moment based the systems endorsed by the Broward County Board of Rules and Appeals. • • • • • • •• • For Uplift based the 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, for each area of the roof, then the the attachment method is acceptable. Method 3 "Moment Based Tile Calculations Per RAS 127" (PI, x L =. x w: _ _ } - W: x cos 8 = Ftt Product Approval V (P2: x L _ _ x w: = ) - W: x cps 0 = Fa Product Approval F ru_. Y t = x w• = Y. W: x cos B ___ = F, _ Product Approval P' Where to Obtain Information Description Symbol Where to find Design Pressure PI or P2 or P3 RAS 127 Table I or by an engineering analysis prepared by PE bused on A,SCA 7 Mean Roof Height H Job Site Roof Slope B Job Site Aerodynamic Multiplier x Product Approval Restoring Moment due to, Gravity 149 Product Approval Attachment Revstance Mr Product Approval Required Moment Resistance M Calculated Minimum Attachment Resistance F, Product Approval Required Uplift Resistance Fr Calculated Average Tde Weight W Product Approval 'rite Dimenwoas L - length W - width Produq Approval All calculations must be submitted to the building official at the time of perant application. • • • • • • FLORIDA BUILDING CODE -- BUILDING 15.35 &� R BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NIIAMT -DARE COUNTY, FLORIDA METRO -DARE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 NOTICE OF ACCEPTANCE (NOA) www.buildinaa►deonline.com Entegra Sales, Inc. 819 N. Federal Highway, Suite 300 Stuart, FL. 34994 SCOPE: .... This NOA is being issued under the applicable rules and regulations governing the use of oonstGUction Ifti is. The documentation submitted has been reviewed by Miami -Dade County Product Control Division and �ptgd " by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and otherMaCwrhere allowgdyy the Authority Having Jurisdiction (AHD). ... • ...... .... This NOA shall not be valid after the expiration date stated below. The Miami -Dade (!&"m Product 4611trol , ... 0 Division (In Miami Dade County) and/or the AHD (in areas other than Miami Dade CoMMVserve the •A§ht to ..;..' have this product or material tested for quality assurance purposes. If this product or maWal fails to 4dc&m in ...... the accepted manner, the manufacturer will incur the expense of such testing and *V= may immediately .' revoke, modify, or suspend the. use of such product or material within their jurisdiction.. BORA reseWH the right • • • • : • to revoke this acceptance, if it is determined by Miami -Dade County Product Control DNObn�that thi dduct or;.... material fails to meet the requirements of the applicable building code. 00000 ' This product is approved as described herein, and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone. DESCRIPTION: Estate "S" Tile LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This renews NOA # 01- 0703.04 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. ('T CO'1 O N, NOA No. 06- 0310.05 Expiration Date: 08/23/11 Approval Date: 07/27/06 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE This renews a roofing system- using Entegra Estate "S" Concrete Roof Tile, as manufactured Entegra Roof Tile Corporation in as described in Section 2 of this Notice of Acceptance, designed to comply with the Florida Building Code, 2004 Edition for High Velocity Hurricane Zone. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the design pressure values obtain by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment beind • • system. 0000 •. . • 66. 2. PRODUCT DESCRIPTION 000:80 6 6 Manufactured by Test Produce • . 6 6 .... Applicant Dim, ensions Specifications Descriptions • • ' 0000 Entegra Estate 'S' 1= 16 -1/2" TAS 112 Low profile, interlocking,' &tided coneraft Roof Tile w =13" roof tile equipped with taro mole and • min.1/2" thick double roll ribs. For dire �t deoi< or ba0AM nail -on, mortar or adhesivpiset IpplicatfUK0 Trim Pieces 1= varies TAS 112 Accessory trim, concrete roof pieces fob W. w = varies at hips, rakes, ridges. and valley varying thickness terminations. Manufactured for each tile profile. 2.1 Components or products manufactured by others Test Product Product Dimensions Specifications Description Manufacturer Rainproof Il 30!'x 75' roll TAS 104 Single ply, nail -on Protect-0-Wrap, 36'x 75' roll underlayment with Inc. or 2" self - adhering top (with current NOA) 60" x 75' roll edge. Ice and Water 36" x 75' roll TAS 103. Self - adhering W.R. Grace Co. Shield underlayment (with current NOA Wood Battens Vertical Wood Preservers Salt pressure Generic Min. l "x 4" Institute LP — 2 treated or decay (with current NOA) Horizontal resistant lumber Min. l "x 4" for use battens with vertical battens or Min. 1 "x 2" for use alone a NOA No. 06-0310.05 { Expiration Date: 08123/11 Approval Date: 07/27/06 Page 2 of 7 .0000• ••.•. 0000• 6 6 •0000• •0660• 0 0 K _ NOA No. 06-0310.05 Expiration Date: 08J?3/11 Approval Date: 07/27/06 Page 3 of 7 Test Product Product Dimensions Specifications Description Manufacturer Tile Nails Min.10dx 3" TAS 114 Corrosion resistant Generic Appendix E screw or smooth (with current NOA) shank nails Tile Screws #8x 2 VY' long 0.335" TAS 114 Appendix Corrosion resistant, Generic head dia. E coated, square (with current NOA) 0.131" shank dia. drive, galvanized, 0.175" screw thread coarse thread wood dia. screws Roof Tile Mortar N/A TAS 123 Prepared mortar Bermuda Roof ("Tilerite'rW) mix designed for Company, Inc, *• mortar set roof tile : a&sent PCA• • • • • .... applications. .. • Roof Tile Mortar N/A TAS 123 Prepared mortar .Goes. •• • . e e e • i�uikrete ...... ( "Quikrete® mix designed for ' �Hrstrucgdr2 • • • :'**0: Roof Tile Mortar mortar set roof the • • . • Aojlucts AV • 86:666 #1140 ") applications. ..'wentIk4:ae ��00�• Roof Tile Mortar N/A TAS 123 Prepared mortar •e•sos ; W . P. Bonsai CIO. G • (`BONSAI.® mix designed for . wity curreatWo e :0000: Roof Tile Mortar mortar set roof tile * e e G • e : .Gee Mix') applications. 000 • s • Roof Tile N/A See PCA Two component Polyfoam Products, Adhesive polyurethane Inc. ("Polypro® adhesive designed AH160 ") for adhesive set roof file applications. Roof Tile Factory premixed See PCA Single component Flexible Products Adhesive canisters polyurethane foam (with current NOA) TileBond roof file adhesive Hurricane Clip & Clips TAS 114 Corrosion resistant Generic Fasteners Min. W' width Appendix E clips with corrosion Min. 0.060" thick resistant nails. Clip Fasteners Min. 8d x 11 /a" K _ NOA No. 06-0310.05 Expiration Date: 08J?3/11 Approval Date: 07/27/06 Page 3 of 7 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set file applications, a static field uplift test shall be performed in accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform . quarterly test in accordance with TAS 112, appendix 'A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayments . shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall bezn• compliance with applicable Building Code. .. •.. • 4. INSTALLATION • • • •.. • 4.1.1 Entegra Estate "S" Concrete Roof Tile and its components shall be installed in.saiGt compliance with Miami Dade County Roofing Application Standard kM -118, RA 118, and RAS 120. •'•••• • •• 4.2 Data For Attachment Calculations :00:0: • • .... Table 1: Average Weight (1N) and Dimensions (1 x w )•.. • ; • • • • . . Tile Profile Welght-W (ibf) Length -1(ft) Width -w ( )• 1 Entegra Estate 'S' Roof Tile 10.0 1.375 1.08 Table 2: Aerodynamic Multipliers - Tile Profile I (ft3) Batten Application ation .% (f e) Direct Deck Application Entegra Estate'S' Roof Tile 0.267 0.289 Table 3: R rina Moments due to Gravi - M ft -lb 711e Profile 3 ":12" 4":12" 5 ":12" 6 ":12" 7 0:12" or greater Entegra Estate 'S' Roof Tile Battens Direct Deck 1 Battens Direct Deck Battens 1 Direct Deck Battens 1 Direct Deck Battens Direct Deck 5.91 6.74 5.82 6.64 5.70 6.50 5.56 6.33 5.40 WA NOA No. 06- 0310.05 ]Expiration Date: 08123/11 Approval Date: 07/27/06 { Page 4 of 7 .....• ...... Table 4: Attachment Resistance Expressed as a Moment - Mf (ft4bf) for Nail -On Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile 3 Flexible Products Company IlleBond Average weight per patty 11.4 grams. Po oam Product Inc. Average wei ht per patty 8 grams. (min 15/32" plywood) (min. 19132" plywood) 5 Medium paddy placement of 24 grams of Po roTm- Entegra 2 -10d Ring Shank Nails 27.8 37.4 28.8 1 -10d Smooth or Screw 8.8 11.8 4.1 Estate 'S' Roof Tile Shank Nail 2 -10d Smooth or Screw 16.4 21.9 7.1 Shank Nails 1 #8 Screw 25.8 25.8 22.9 2 #8 Screw 47.1 47.1 49.1 1 -10d Smooth or Screw 24.3 24.3 24.2 Shank Nall Field Clip) • • •. 1 -10d Smooth or Screw Shank Nail Eave Clip) 19.0 19.0 . .. 22.1 *00* • •. 2 -10d Smooth or Screw Shank Nails Field Clip) 35.5 35.5 " " ; .. 34.8 • • see 2 -10d Smooth or Screw Shank Nails Eave Clip) 31.9 31.9 '. 32.?::: • " • • 2 -10d Ring Shank Nails rT 43.0 67.5 50.900-- 1 Installation with a 40 Ile headiap and fasteners are looted a min. of 2W from head of Ule. • • • ' ...• . • • .. Table 5: Attachment Resistance Expressed as a Moment Mf (ft-lbf) • for Two Patty Adhesive Set S terns Tile Profile Tile Application Minimum Attachment Resistance Entegra Estate 'S' Roof Tile Adhesive 26.1 2 See manufactures component approval for installation requirements. 3 Flexible Products Company IlleBond Average weight per patty 11.4 grams. Po oam Product Inc. Average wei ht per patty 8 grams. Table 5A: Attachment Resistance Expressed as a Moment - Mf (ft Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Entegra Estate'S' Roof Tile Polyfoam PolyProTm 86.61 Polyfoam PolyProTm 45.5 4 Lame paddy placement of 54 grams of Pol ProTm. 20.60 5 Medium paddy placement of 24 grams of Po roTm- Table 59: Attachment Resistance Expressed as a Moment - Mf (ft Ibf) for Mortar or Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Entegra Estate 'S' Mortar Set 20.60 Roof Tile { NOA No. 06- 0310.05 Expiration Date: 08/23/11 Approval Date: 07/27/06 Page 5 of 7 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below), or following statement: "Miami -Dade County Product Control Approved ". OR V<EE�7E N T E S R ❑ � 9999 • 900.6• ETAE "S" Diz LAEL (OATD ON UNEIDE OF TL I 96 99 ' • . • . • • • • • • ..0 . 666• 99.6: 6. BUILDING PERNIIT REQUIREMENTS see: 6.1 Application for building permit shall be accompanied by copies of the follov kk. ; 0 • • • . , ; , • • 6.1.1 This Notice of Acceptance. " 9999.. 9999 6.1.2 Any other documents required by the Building Official or applicVle t0iiilding Code • in order to properly evaluate the installation of this system. . • • • • • • • • • :. ,•• 9999 • . _ NOA No. 06.0310.05 Expiration Date: 0W23/11 Approval Date: 07/27/06 Page 6-of 7 Nail Holes a PROFILE DRAWING ENTEGRA FMATE "S" CONCRETE ROOF Tux END OF THIS ACCEPTANCE 6666 , • • 0000 46666• 64 Y 464 •• •• • 646444 r ••• •.• , 600.6 ; • • • • 66666 46666 666• • •• • ••666• • 666 • • • ��� 1 •666 00.0.4 0064•• , • • 6606 • • 46446• 0•• • 0000 , •4 • 66 4 •0066• o NOA No. 06- 0310.05 _ { Expiration Date: 08123/11 Approval Date: 07/27/06 Page 7 of 7 M I A M I•DADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION _NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Prod �t* • Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Havity� • • • • Jurisdiction (AHJ). '• • . • 000 • • . 000000 see . This NOA shall not be valid after the expiration date stated below. The BCCO (In Miami Dade4ndy) and/or. the :"00*: AHJ (in areas other than Miami Dade County) reserve the right to have this product or mateIN tested for quakty :0000: assurance purposes. If this product or material fails to perform in the accepted manner, the maAfttturer wi}1okc& 0 0 0 0 0 the expense of such testing and the AHJ may immediately revoke, modify, or suspend the >:s�:o dich p*dpt#pr •.:..' material within their jurisdiction. BCCO reserves the right to revoke this acceptance, if it is �:: •ermined by'DECO • •.. o. that this product or material fails to meet the requirements of the applicable building code. • 0 •• •...• 0000.. This product is approved as described herein, and has been designed to comply with the High Va�&ty HuftMe .0. ... : 00 Zone of the Florida Building Code. • . .• . DESCRIPTION: Polypro® AH160 RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA No.01 -0521.02 and consists of pages 1 through 7 The submitted documentation was reviewed by J rge L. Acebo. NOA No.: 06-0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 1 of 7 ROOFING ASSEMBLY APPROVAL: Category: Roofing Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves Polypro® AH160 as manufactured by Polyfoam Products, Ina as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using le Patty Placement, and as an uplift attachment based system for double patty systems moment based system for single patty PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test 18 PSI Parallel to rise Specifications Polypro® AH160 N/A TAS 101 Foampro@ RTF1000 N/A ProPack@ 30 & 100 N/A Product Description Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro AH160 roof file adhesive. PHYSICAL PROPERTIES: Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 Cell C -tent ASTM D 2856 Results 1.6 lbs. /ft' 0000 18 PSI Parallel to rise 12 PSI Perpendicular to rise ' • • • • • 28 PSI Parallel to rise • • '0000• • • • • 0.08LbsJFtZ •••��• 3.1 Perm / Inch +0.07% Volume Change @ 4X Fe,'2 weeks; • +6.0% Volume Change @15&°F4.1M% .. . Humidity, 2 weeks • • • • 0 • 0000 86% 9'9 Closed o *0 00 Note: The physical properties listed above are presented as typical average values as determinea•' by accepted ASTM test methods and are subject to normal manufacturing variation. NOA No.: 06- 0201.02 ` Expiration Date: 05/10/11 f Approval Date: 04 /13/06 Page 2 of 7 0000.. 0000.. 0000.. 0000. 0000. 0980V 8. 999999 9 9 0000.. EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Repo rt Date Center for Applied Engineering #94-060 TAS 101 04/08194 257818 -IPA TAS 101 12116/96 Trinity Engineering 25- 7438 -3 SSTD 11 -93 10/25/95 Celotex Corp. Testing Services 25-7438-4 TAS 101 10/23198 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB- 589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739 -062b[l] ASTM E 84 01116195 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 5284542 -1 TAS 101 10/23198 5284549 -1 52845410 -1 520109 -1 TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 TAS 101 03/02/99 520109-2-1 LEVHTATIONS: 1. Fire classification is not part of this acceptance. Refer-to the Prepared Roof Tile Alsen1bly for fire • • • • fig• .. ... 2. Polypro® AH160 shall solely be used with flat, low, & high tile profiles. " "" • 3. Minimum underlayment shall be in compliance with the Roofing Application Stagg4tA. S 12;.' • 4. Roof Tile manufactures acquiring acceptance for the use of Polypro® AM 60 roo£tjJp•qjhesive with . . their file assemblies shall test in accordance with TAS 101. .... 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof h'le,adhesive with . their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein • • • • F- W MS NOA No.: 06- 0201.02 w Expiration Date: 05110111 Approval Date: 04 /13/06 Page 3 of 7 INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® A11160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof the assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile, assembly NOA 3. Polypro® AH160 roof the adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® AH160 shall not be exposed permanently to sunlight. S. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Min. arcs Two Paddy Weight per paddy Min. amp) • Flat, Low, High Profiles #1 35 'hT,iA High Profile (2 Piece Barrel) #1 17 /side on cap and 34/ an ilelf 8,• • Flat, Low, High Profiles #2 24 •1.T(,Q„ • • Flat, Low, High Profiles #3 .. g... 666 0000 0000 LABELING: • • • • • • • 0000 All Polypro® AH160 containers shall comply with the Standard Conditions listid hergin. • • •.' BUILDING PERMIT REQUIREMENTS: • • • • • As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. NOA No.: 06- 0201.02 - ME Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 4 of 7 0.60.0 •• 0000.. 00000• ..••. . . 0000. 000..0 . .00.00 .0000. • AmEsm PLACEMENT DETAIL I SINGLE PATTY NdbOUgh PwfteemeM Peafty 'poem Tb) ummumat j 10 fn EMIrYW00 �w FMIA tm wmeeo* I.i '�1:•r ail i'. � .I�:.. �:I� ii II i • • • •••• •••• • • •••• •••• ••••• •••••• • •• ••••• • • •••• •••••• 00 a NOA No.: 06-0201.02 _ w Expiration Date: 05110111 Approval Date: 04113/06 Page 5 of 7 �w • • • •••• •••• • • •••• •••• ••••• •••••• • •• ••••• • • •••• •••••• 00 a NOA No.: 06-0201.02 _ w Expiration Date: 05110111 Approval Date: 04113/06 Page 5 of 7 Un�r�yment . EsneComse EMCWBUM c'K 1p71 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY PA* (Boned o) Nd Rough PIN& Connt UWedaym nt 1 ln%'�2 h 1 � Fesch Em cm / Closure a* NOA No.: 06-0201.02 Expiration Date: 05110111 Approval Date: 04/13/06 Page 6 of 7 0000.. 0080.• 0000.... 0000 • . 0080• 8000.•.• • 8080 • 0000...• 8000•.•• • . • 8080...• 0080.. ..•. 0000•. 0080.. 0000... 0080•••• . 0080 .0000 .. .. • 0000.. . . .....• as • • 008000 .0000. • . 000006 . . . . . ....• 0000 . 8000 . . • . . so 0 NOA No.: 06-0201.02 Expiration Date: 05110111 Approval Date: 04/13/06 Page 6 of 7 Nag through plastic cement I to I x 3 In. 3 in. ladder We ` Single paddy on 21n. 4 hu under- Engle paddy on top of the ADHESIVE PLACEMENT DETAm 3 DOUBLE PATTY paddy Nag through plastic (between tie) lhuiarlaymant Oder Ile) taus coum In X 7 IL mecunm size paddy am ch • course only Hall through plastic cer►m /nt �In.x3Im 4 Single paddy 2 onundedayment ° Single paddy on top of the Eave come t t }�e' 3 hux 3 Im Single 41n. 2In. paddyon undue laymerd Single paddy on top of file Fare Cause Single paddy under 1119 Single paddy between the 21n. x 7In. medium size paddy am PMM only Sbgw I between ft ftx an cow" only END OF THIS ACCEPTANCE %` Fade `Weepw ave closing Ddp edge NOA No.: 06- 0201.02 a Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7 • 6 . . 0.0. 6000.0 •. • . ... • . . 6666.. •. • 6.666. 6666.. 0000 000• 00669 000000 . .• •000• . • .. •• •• 0006 •.6..• • 0.60•. ! 6 •0.. 000000 • 0000 . • . 666.6. .• . .• • • • . 0 .. • NOA No.: 06- 0201.02 a Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7 Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section , C (Low S1q�e ApRilca#tion) Fill in specific roof assembly components and identify manufacturer (if a component is not used, Identify as "NA") System Manufacture'- .d- tiET Product Approval No. .7- Design Wind PU essures, From RAS 128 or Calculations: Pmax1:8 Pmax2: Pmaxl° QS la 3 Max. Design Pressure, from thUpecific Product Approval system:--.n Deck: Type: lJ�� Gauge/Thickness: ' Slope Anchor/Base Sheet &tooZh�er/Bondlng ): Anchor/Base Sheet Fa Material: Insulation a Layer: Base Insulation Size and Thickness: Base Insulation Fastener/Sopdfina Material: Top Insulation Layer 4 Top insulation ,0tze and Thickness: Top insujAon FastenerBonding. Material: Surfacing: Fastener Spacing for Anchor /Base Sheet Attachment: Field: ��` . " oc @ Lap, # Rows ctp? @ � " oc Perimeter: �,O "' oc @ Lap, * Row"s T 0 LO is Oc Corner: LP " oc @ Lap, : Roves 4 @ LP " oc Dumber of Fasteners Per Insulation Board: r� 1 Field 4 Perimeter Comer Illustrate Components footed and Details as Applicable: AloodblocWng, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter - Flashing, Coping, Etc. Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit Roof . Mei hf � Base Sheet(s) & No. of Ply(s) �5 �� .�! , ' :t:: g . • •I •. Base. Sh�et Fastener/Son ing Ala ri : ! • • loci 1 T 9 ��yy ¢¢ i Ply Sheet(s) & No. of Pty(s): V 0 O 1 Ply Sh�egt Fastener/Bonding � �� - - .. - - Top Pty: i TMD 909 I ` T i Top Ply eyner/BondtMaterial- ..•P arapet:.. •. • • • Mel ht .' ' 0.000• 0000 .. .. • Mean ...I. �. Roof . Mei hf � Base Sheet(s) & No. of Ply(s) �5 �� .�! , ' :t:: g . • •I •. Base. Sh�et Fastener/Son ing Ala ri : ! • • loci 1 T 9 ��yy ¢¢ i Ply Sheet(s) & No. of Pty(s): V 0 O 1 Ply Sh�egt Fastener/Bonding � �� - - .. - - Top Pty: i TMD 909 I ` T i Top Ply eyner/BondtMaterial- BUTa :DMG CODE COMMUNCE OP "CP TCf'O) PRODUCT CONTROL D1V1iitION NOTICE OF ACCEPTANCE � GAF Material Corpora!%n 1361 Alps Road. Wxync, NY 07470 MUM%DME COUN'1'lt, FLDMA D'lt M0- DAW -MAGM RURDM 140 w T n A.a= S'17t w surm 1603 M1AMFWMA 33i3/i-1M (305) 375-2901 FAX (305) 375 -2909 SCOPE: TWs NOA is being issued under the applicable rules and regulations.governing tht use of construct materials. The documentation submhW has been reviewed by the BCC:O and accepted by BuDduag Code and Product Review Commode to be used in Miami Dade County and other areas where allovied by the Authority Ekvmg Msdictiom (AH]). This NOA shall riot be valid after the expiration date stated below. The A+ umiDade County Product Control Division (in Miami Dade County) and/or the AM (in areas other than hawra Dade County) reserve the night to have this product or material tested for quality assutwee pmt. If this pry or mauaW fails to pafotrm m the accepted mariner, the .manufacti met will imcur the expense of such testing: and the AM may ummxhately revoke, modify, or suspend the use of such product or material within their jurb4ctim BORA reserves the right to revolve this acceptivice, if it is determined by Miami Dade County Product Control Division that this product or material fails to mod the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Aigh Verity Huaicane Zone of the Florida Building Code. DESCRnMON: GAF CAaveK110aal Built,. UP Roof Sys for Wood DecL .LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered alter a renewal application has been tiled and there has been no change in dy-, applicable building code negatively affecting the perfamume of thb product. 0000 TERMWATION of this NOA will occur after the expiration date our if there has been& ravwon or OUR in the 0' 0: 0 materials; use, and/or manufacture of the product or procem h isum of this NOA was an 0 0 0 0 0 erg$ f sn% 0 0 0 0 0 product, for s ales, adverdsmg or any otter purposes ill autonoatically teranateithis kJQ ' ure to c�mPly . with any section of this NOA shall be cause for termmatiosn and removal of NOA_ 0 0 0 0 0 0000 0000 . . 0000 0000 0000. ADVERTISEMENT': The NOA number preceded by the words Miami I}ade C;om0,40krift, an f foftwed b�- 0 0 0 the expimfion. date }maybe displayed in advertising literature. If any portion of the NOW is'aisplayed,• tt'h it shall• 0.:* be dome in its entirety. 000000 0 • . . 0000 0000.. INSPFXn0N: A copy of this entire NOA: shall . be provided to the user by the m�anu Fr its dim ors � • • • • and shall be available for inspection at the job site at the request of the Building .. 0 0 . 00 • This NOA rows NOA M'LW&09 and consists of pages 1 through 21. The submitted documentation was reviewed by Frank Zuloaga, RRC: NOA No: 434381.05 i n Dote MAW03 Approv id Baw.IWAW Np 1421 10A B Deck Type 1. Wood, Non - insulated Deck Description: "132- or ;;rcat'r plyood-cr woa d flank decics . Systems Type E (1): Base sheet mechanically. fastened. All General and System Limitations :,hall 'a7pply. Base sheet: GAFGLAS #80 UltimaTm Base Sheet, STRATAVEN @ Eliminator Perforated Nailable, RUBEROID Modified Base Sheet, RUBEROMQ 20, RUBEROID SBS Heat We1dTm Smooth or RUBEROID SBS Heat -Weld 25 base sheet ' mechanically fastened to deck as described below; Fastening Options: GAFGLAS0 Ply 40, GAFGLAS-Flek P1yTM 6, GAFOLAS n75 Base Sheet or any of above Base sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two . rows *12' o.c. in the field. (Maximum Design Pressure -45 psf, See General Limitation GAFGLASO Ply 40, GAFGLAS Flex Plyw 6, GAFGLAS #75 Base Sheet or any of above Base.sheets attached to deck with Drill-tec (GAFT'1TL") #12 or #14 Screws and 3" Plates, l2" ac, in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure -45 psf, See General Limitation #7) GAFGLAS Flex P1yT9 6, GAFGLAS #75 Baset,gr any of above Base sheets attached to deck wi approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" la red and in two rows 9" o.c. in the field. (Maximum Design Pres e -5, f, See General L' imitation � GAFGLAS #75 Base Sheet or an a Base sheets attached to deck with hill Tec (GAFI`ITE) #12 or #14 Screws and 3" Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure -60 psf, See General Limitation #7) Any of above Base sheets attached to deck approved annular ring shankpn k- • and 3" inverted Drill -Tec (GAFIM) insulation plates at aXastftr spac&Tdf • • • •; • 9" o.c. at the 4" lap staggered in two rows 9" in the field. " "' '..' 0 ' 0000. (Maximum Design Pressure -60 psf, See General L zita4;ii �jI 0000:. GARMAS #75 Base Sheet or any of above Base sheets attaWad to deckmA :' • • •: Drill -Tec (GAF= #12 or #14 Screws and 3" Plates, 8" ao 4 4 row's. W 0000. row is in the 2" side lap. The other rows are equally spaced agpigximatplx 9a• • • • • 00 •• 0000 o.c. in the field of the sheet. 0000.. . (Maximum Design Pressure. -75 psf, Se e General Lim itat vn V4 � � � Ply Sheet: • • • One or more plies of z&EQL-AS ®P._LY ate, GAFGLASO VLY 0 ply S4%fit. • •.� • • . #80 Uldma, RUBEROID MOP Smooth or RUBEROID 20 adkIA in a fail . mopping of approved asphalt applied within the EVT range and at a rate ofle- 40 1bs. /sq. Cap Sheet: (Optional) One ply of GAFGLASO Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the range and at a rate of 20401bs./sq. y NOA. No: 034501.05 Expiration Date: 1L04108 Approval Dats:10t=03 . - Page 18 of 21.' ' 2004 ROOFING MATERIALS AND SYSTEMS DIRECTORY ROOF COVERING MATERIALS (TE:'T) Roofing Systems (TC,FW— Continued ASPHALT FELT SYSTEMS WITH HDT ROOFING AWHAL: Type G2 t glass mat base sheet ( "GA�`,A.G #75 Boise Fhe^t" or "GAFGLAS #80 ) Is a suitable alternaoe for i'ype G)- aspitalt glass fiber ply sheet( "GAFPLAS Ply 4" or "GAFGLAS Ply 6" ) in the Class A, B or C roof systems indicated below. The roof deck may first be'copered with a Type G2 asnhalt glass mat hasp sheet "GAP Stratavent Niminator Venting Base Sheet (.0ei5omt_,#1 or "GA's Skatavent Eliminator Venting Base Sheet (Nallabler . Perfoivted to be mopped and naihtble to be mechanically attached gramileside do►i: As anopNonTypa G2 asspphalt glass mat base sheet ( "GAPGLAS #75 Base Sheet', "GAIGI:Aly #g0 ULTIMA" or "GAFStratavent'BUfninator Venting Base Sheet (Nailabte)" may be substituted for GI asphalt glass'6ber ply sheet the ( "GAPGLAS Ply 4" or "GAFGLA3 Ply b" j as the nail�t base ply in no systems Bow plyy dr.baw sheet maybe solid mopped, spot mopped or •mechani cannyy faateni .Tripes otherwise indicated, all•insulations-may be hot mopped, or mechaW- cally fastened... _. ,,....:. . "GAFGLAS Fhtshing' or "Ruberoid" may be used for flashing -in any of the Class A, B or. C systems fisted below. When " perUte" is referenced, this includes "GAFTSMP PERMAUrW or any other UL Classified perlite insulation. Crushed stone or.slag are suitable alternates for gravel in any of the Class A, B or C system listed. Structural cement fiber buUding units are considered •suitable to be included as a deck in the follcn, Class A, B or C systems lisfed over C -15/32 or NC. The use of gypsum board under an of the following Class A, B or C systems does not adversely effect the rating. The use of 1/2 iii: min gypsum board is an a��e taple alternate for insulation over C -15/32 decks. The use of lystyrene insulation board between min•3 /4 fn rlite board and deck w rosin .paper (perlite /rosin paper /ppoolystyreneipererlite) is a suitable alternate for Isocyarturate board in the folloling Class A, B or C systems. " BMCA uard RA ", "BMCA Tapered finergyGuard RA" and "BMCA ward W may be substituted for any Atlas polyisocyantuate insula- tion y'' of the following Classifications. Thtmbull "Perms M be utilized with any of the following "Asphalt Felt S with Hot hoofing Asphalt ". GA� ON Premium Base Sheet may be used in any of the following "CAFGLAS Flex Plyy 6" is a suitable alternate to "GAPGLAS Ply 6 ". "GAF1'W Periila -te Recover Board" may Cla be used in lieu of any perlite insulation in any of the following NC Classifications. Class A, B and C Hot roofing asphalt, for usq with organic and glass felts or modified bitumen membranes. "Ruberoid llqar Weld" SBS roofing membrane may be used in lieu of "Ruberoid Mop" SBS products in any applicable Classification. Class A 1. Deck. Incline: 3 Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, wood fiber /isocyanurate composite, phenolic, any thickness. Ply Sheet: Three or more layers Type G1 "GAFGLAS Ply 4" or "GAFGLAS Ply 6 ", hot mopped. Surfacing: Gravel. 2. Deck: C -15/32 Incline: 2 Insulation •(Optionalh One or more layers perlite, wood fiber, glass 'fiber, isocyanurate, urethane, perUte/isocyanurate Composite, perlite/ urethane composite, wood h"ber /isocyanurate composite, phenolic, any thickness. Ply Sheet: Three Or 'more layers Type G1 "GAFGLAS Ply 4" or "GAFGLAS Ply 6 ". Cap Sheet: One layer Type G3 "GAFGLAS Ibtinerai Surfaced Cap Sheet ". -3. Deck: NC Incline: 2 Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, iancyanurate, urethane, perUte /isocyanurate composite, perlite/ um*ww composite, wood fiber /isocyanurate composite, phenolic, •2 in. max. Ply Sheet: 11vo or more layers Type GI "GAFGLAS Ply'4" or "GAF- GLAS Ply 6 ". Cap Sheet: One layer Type G3 "GAFGLAS Ialineral Surfaced Cap Sheet ". 4. Deck: NC Incline: 1/2 Insulation: One or two layers "Isotherm R ", 4 in. max, hot mopped. ROOF COVERING MATERIALS (iEM Roo.�in� gg Systems (TUM— Continued Ply Sheet: Any-,UL Classified gravel surfaced Class A asphalt gh mat system.. . 5 Deck: C -15/32 Incline: l Slip Sheet "onalk. Rest rosin:paM nailed to deck. Base Sheet: Of)e layer Type G2• "GAFGLAS t)75 Base Sheet: (: nailed). _e Ply Sheet:. -:One or more layers Type G1 "GAFGLAS Ply 4 ' yr GA Ply 6" Cap Sheet: One layer Type G-3 "GAFGLAS Mineral. Surfacf Sheet'; -• 6. Deck NC Indine 3 Base Sheet: Orte layer Type G2 "GAFGLAS 95 Base Sheer'.. ; Ply Sheet: Ono or more layers Type Gi "GAFGLAS Ply CAF GLAS Ply 6 ". Cap Sheet- Orle layer Type G-3 "GAFGLAS Mineral Surface Sheet'. 7. Deck C -15/32 Incline: 2 Irtswatton: • °One or more= layers perlite, glass fiber, isocyanurat• one, perlite /isocyanurate composite, perlite /urethane coniipOgtt nolic,1.0 in. mini (offset from plywood joints 6 in.). Base Sheet: 01* or more layers-Type G1, G2 or G3. Membrane Ong or more layers'Ruberoid Torch" (Smooth or Grf 'Ruberoid Torch Plus" (granule), "Ruberoid Mop" (Smooth or Gr. or "Ruberoid M¢p PIus" (granule). Cap Sheet "GAFGLAS Mineral Surfaced 2 Sheet", hit mopl 8. Deck C -15/32 Insulation (Optional) One or more layers perlite,' wdoA fibft fiber, isocYanur*, urethane, perlite /isocyanurate composite,, p urethane composite, wood fiber /isocyanurate composite, phcnoli: thickness. Base Sheet: Ttvp or more layers TM G2 or G3. Ply Sheet (Opticinal): One or more layers Type Gl. Membrane: One or more layers "Ruberoid Torch" (Smoot(n o¢ Gra: "Rulmmid Torch This" (granule), "Ruberoid Mqp" (Smooth or Gra or "Ruberoid MqP Plus" (granule). Cap Sheet- "GAFGLAS Mineral Surfaced Cap -Sheet', hot mopp Class B I. Deck: C -15/32 Incline: 3-1/2 Insulation (Optional): One or more layers perlite, wood fiber, fiber, isocyanurate, urethane, perlite /isocyanurate composite, pet urethane composite, wood fiber /isocyafit* to jomposite, phenoli c. thickness. . • "000 sees*** Ply Sheet: TWO -or m8Wj" 'Type q `'p�gGLAS ply ror "( GLAS Ply 6" • • • . Cap Sheet: Type G3'� &CLAS M'irM Surfaced dap ISMet", mopped. • • • • • • • • • � G -Y /2 ••�••• 2. Deck: C -15/32 0000 • • Insulation (Optional)?�'r more .perlite. n000d•Sbei, 1 fiber, fsocyarturafe, uretbWw. Whte /4oe *Vuate corapq'sjto,'pei urethane composite. w.00 #b,&/bocy a cbmposif&IjUitplic, thickness. Base Sheet: Two or nt)V its G1, & or G3. Membrane: On or more layett; "Itu 03_ �dlBidtr�„ (Smd�lt8r'Qram "Ruberoid Torch 'tus" {grant fie), "R (Sin %t or bran Or'Ruberoid Moi) Plu'I".(glan(,i1e). • • • i i Cap Sheet: "QFGLAS Mineral Sudf3q4 Cif Sheer, hot moppe= Class C Deck: C -15/32 ••Incline: 1/2 Insulation (Optional): One or more layers perlite, wood fiber, g fiber, fsocyanura , urethane, perlite /isocyanurate composite, pert. urethane comp"tte, wood fiber /isocyanurate composite, phenolic, thiclatess. Ply Sheet: Three or more layers Type Cl "GAFCLAS' PI 4„ "GAFGLAS Ply W. Ply 'C "Speliaal Roofing Bitumen" 20 Urn /sq. COAL TAR FELT SYSTEMS WTrH HOT ROOFING COAL TAR Class A Deck: C -15/32 Incline: 1/2 Insulation (Opti'nal): One or more layers perlite, wood fiber, gl fiber, - isocyanuraf�, urethane, perlite /isoeyanurate composite, perg urethane composite, wood fiber /isocyanurate composite, phenolic, a thickness. Snefacing. (Requhad if ho cap bheet is used) in%W one of the following. i. 4AW Spedai Roofing Ait(w with an rate of 201bs./sq with an applicatraa tate -Y-9 1 c galJsq .; or GAF COAT@ Emulsion (Matrix 305 Fiber Emulsion) with an application rate of 3 galJsq.; or GAF Premium-PUx sed Aluminum Roof Coating ( Matrix System Pro Aluminum Roof Coaft Fin gyred 301) with an- application nape of 1.5 pUsq. Z .Asphalt Owd coat a: awapplicadon rate of 60 Pao Jsq. * 20%; plus gravel or slag with an application rate of 400 ibsJsq & 30016sJsq., mspectively. 3. Top Coat Surface Seal SB (Matrix 602 SB CoatWg), Top Coat MS plus (Matrix 715 MB Cuing), GAF WeathmCote or WadwCote LOW YOC appfi at rate of 1 -1.5 gel/sq. i�lamnm . Pressimre: Sw Faftning Above - e. NOA, No.- 03-05 1.05 Nwhidon Date. U10410$ A.pprovQ Date.I0/2W Page V of 21 see oo ..•.•• . •. ••i••• • • • • . 00 04, •.•••• • • • •... • • e. NOA, No.- 03-05 1.05 Nwhidon Date. U10410$ A.pprovQ Date.I0/2W Page V of 21 WOOD DECK SYST.if:M LIMITATIONS: 1 A slip sheet is requi%d wish fly 4 anti Plox Ply 6 whm -used as a meOpoically fastened base or anchor sheet. 2. hfinimum W Duets Deck or % Type X gypsum board is ale to be Installed directly over the wood deck GEN=AL LawATtONS; I. Fare classification is not pact of this manes, refer to a current Approved Roofing Matezials Directory for an ratings of this product. 2.- boulation may be installed in multiple layers. The first layer shall beached in compliance with Product Control Approval guidelines. All other layers shall be adhered io a foil mopping of &Fp�'ed aprpiied within the l3V'I' range a> at a rata of 20--04 Ibsaf .. or maghanicaliy attached using the faskning potkwn of the top layer 3. All stand pawl sizes are acceptable for mechanical at t. When applied in approved asphalt, paw size shall be 4' x 4' nuxhn m 4. An overlay and/or recovery board insulation panel is required on all *Hcatlew over closed cell foam insulations when the bow sheet Is fully mopped. If no recovery §owd is used tha base sheet shall be applied using spot mopping with approved asphalt, 12" diame* circles, 24" o c.; or strip mopped r ribbons in tbm rows, one at each sideiap and am down the: hunter of the sheet allowing a continuous area of ventilation Encircling of the strips is not able. A 6" break shall be placed every 12' in each ribbon to allow crom ventilation. Asphalt application of either system shall be at a minimrarm rate of 12 lbsJsq. Note; Spot attoke d sydeaom shag be Hm&d to a � din pressure of -45 psf. 5. Fastener spacing for insulation attachment is used on a Moo lmom Charaptedstic Force (F) value of 273 IbL as tested in c=%Aw= with Testing Application. Standard TAS'10& If de ihstener value, as field- tesftA ere below 275 ibfi insulation attachment shw not be acceptable. 6. Fastener spacing for mechanical attaclu meat of anrhoarlbase shot or nx=#me attachmut is based on a nxiuimum fastener resistance value in couj7mcdon with the MUAMUIJA design value listed within a specific system. Should than fastener resistance be Iow than that requix4 as del by the Budding Official, a revised fastener spacing, prepared, signed and seaW.by a Florida Registered Eugineear,. Architect, or Registered Roof Consultant may be, submitted. Skid revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. • • • • 7. Perimeter and comer areas shall comply with the enhanced uplift. pressure req-u�remenfs of time • • • •: • areas. Fastener densities shall be increased for both insulation and ban 16i as ce WMjd in • compliauce with hoofing Application Standard RAS 117. (Whim this Rg"qn is speWlcally . . referred within this NOA, General Limitation #9' will not be applicable.) .... .... • • • • 8. All attachment and sizing of pert inter nailers, metal profile, and/or flasbing 6waAdon &sW ..... shall conform with Roofing Application Standard RAS I I I and applicable regnts. • •:..' 9. The maximum designed pressure 11mitahon listed shall be applicable to all rc tlf Maurer zot a tire. • • • • • field, Viers, and comers}. Neither rational analysis, nor extragolat Cohn 94M tted fir '. enhanced fastening at enhanced pressure zones {ire, peai�ters, extende l cotters coma ,'. • • • • • • (When tills limliad(m Is speMcally referred wid& this NOA, Genetal tf ou #7 Wnot � • • • • be applicable.) 999* 66 10. All products listed herein shall have a quality assurance audit in accordance with, the Florida. Building Code and Rule 9B-72 of the Florida Administrative Coda. END OF TEM ACCEPTANCE �, NOA, No: 03d1MAS "` E`RphWbu Date a 1I/ WOB Anw vai DvAwI AIW Fs Me 21 of 21 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION OR Bk 26369 Ps 2388; (fps) RECORDED 05/09/2008 09 :28 :03 HARVEY RUVINP CLERK OF COURT l nIAnI -DARE COUNTYr FLORIDA PERMIT NO. TAX FOLIO NO. f /' ?Z • &D' /)/3- 6231) STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. LWal description 2. Description of im Z interest in property: 4. Contractors name and addr ss: I 1; E-19 A44 -4 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: STAIS OF FLORIDA, COUNTY CF 15A1�g Amount of bond $ ���y "�f' � "'i� °� .r °n 6... Lender's name and address: `� T , 7. Persons within the state of Florida designated by Owner upon whoa' n is s r eQ wAmts%ay b steed' as provided by Section 713.13(1)(a)7., Florida Statutes. y 8. In addition to himself, Owners designates the following persons) to receive a copy of the Lienors Notice as in Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) OA _L_ Green River Capital LC as Attorney in Fact Signature of Owner , l Print Owner's Name Prepared by Sworn to and subscribed before me this day o 20 , F Address: Notary Pub Print Notary's ame: M commission ex 'res Y_.. __ . -s ...... r s F 1 fit .._....�_ 4 dis Miami Shores Village ' Building Department r : 56 : 2-nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Job Name Date Y p BUILDING CRITIQUE SHEET Reviewer: Claudio Grande C.B.O 305 - 795 -2204 Ext 1430 05/12/2008 16:51 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES A TRANSMISSION OR T% /R% NO RECIPIENT ADDRESS DESTINATION ID ST. TINE TINE USE PAGES SENT RESULT aaaxc�x�e�s��excax��x�xa��xaxe�x�� xcxe T% REPORT a�exe ��k�k� &�&�k�ae�kxcaeskxcxc�&��xe &s��& 2047 93052789028 05/12 16:51 00'30 1 OR Miami Shores Village Building Department 11001 100,50 KE.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit N0. Job Name -%✓�l Date =S I Y L1 BUILDING CRITIQUE SHEET a r d �1 U�n 5ffi GREEN RIVER CAPITAL 220 Morris Ave suite 300 Salt Lake City, UT 84115 Subject: 98 NE 103 st, Miami Shores, FL 33138 To whom it may concern, It is understood that Green River Capital is a legal acting representative of EMC Mortgage Corp. (current owner) as designated in the accompanied executed power of attorney. Green River Capital is authorizing Amadi Roofing and its subcontractor, Ocean Blue Contractors, Inc. to pull all required permits, replace the roof, and fulfill all other roof - related requirements of Miami Shores Village Building Department. Thank you for your assistance. Please feel free to contact me at your discretion. Thank you, 710dM11,101 JC Corn Green River Capital 801 - 456 -3234 jcorn @greenrivercap.com Miami -Dade County Clerk - County Recorder's Record Search - Image Display Page 2 of 3 CFH 200681071633 I a 74M Pa 78531 b) MM 10/05/7 613:74:10 EVTEEMA1fPMWOP'DIEI 31, DEED Td %D.bO IOft'ffT Cz v OgIRT CIB WINAt0 ODADEtA10,01DA W -WE CWP FM �^ ` LET GENFRNLNRiS1TCTIUNISION (2VE,AMONNO.65E17 S1R;.02 NCUTOAGB(EIRPORATION, I'liE(s)IPetd(s) w< DOIMPARENI FUVING,ANOIPDEAD,THE0N OWNwISE dd (s)II (s) CERT[FICATBOFT[TI,E C4i__. THE OIIDERSIfdI1R1 CLF1tN OF � Comt CaGOas 8nt a Calm of Sale was aml � m dtis adios � Sew 2D, 2D�, f� 9a deed laaem a� Val obj�s io rbe ade)we eit>ffi � 6ae4 fife within �a tiow a0ow� 6p s�tmy Ow � d' filled„ � few � 6y6xsomtllx�opatgmDadeCaoOy ,Flaida�ddafoEaa� LMIA82BM 20FMOihESEDEEECDIONIAEMACCORDINGIOMPIAT P, ASREOD SINPIATB001; 10PA0E760FTEEPOELICRE (2I11II30FJiM.DADECOONfY, FIIIRIDA wassoldM: EMUORTGAGE OORPORATIOX doDaMdStem,P.A, CIS• Uoi�ityDri� ,S�eS�,Plaotatt�,Fbrida • VPMmyWmdsWdfiCmdm Odk3,N 'd ? }Spy W0,40771De AR41 P AIE'3f<I18IMIAII Dw 4 Af 4 �,. u_ :.,._:< ii =, ,_ i, i. -n is au ■:.= _...u+ '�l n '• n ! : e u be- TIMTIIM2, i. hq:// www.miami- dadeclerk.com/public- records /image.asp ?page =l &cfn master id= 1957... 5/21/2008 7- I_'`. V, MUTED POWER OF ATTORNEY U RMC Mortgage Corporation (hereinafter the "Company "), a Delaware Corporation with its Principal. place of business located at Lewisville, Texas, constitutes and appoints all3ndividuals With the signatory authority of Regional Vice President, Vice President, Assistant Vice President or abovewho are employees of-Green River Capital Corporation, a Utah Corporation, ad such-other person or persons as any of them shall designate f%om tune to- time,•and each-of them, any. of %vhom•may aot•alone, the true and lawRal attorneys -in -fact of $a Company, with respect to anyreal property interest that-the Company currently has or hereafter may have to do or perform in the name, place and dead and for its use and benefat, to execute, endorse and acknowledge all documents customarily and reasonably necessary and appropriate for the facilitation and the disposal of 12130 properties owned by or serviced by the Company. Such power shall Include„ but not be limited to the follolving; 1. The. #aoilitafion of the marketing and disposal of RBQ propertles.(i) owned by the Company or (ii) serviced by the Company for others-Pursuant to an agreement that authorizes the Company to.dispose of such FM properties, for such price and to suehperson orpersons as the attorney -itt -.tact 'shall deem proper and conveniont, including the oxeeufion, acknowleftentetit, delivery, filing and recordation of*a deed or deeds of convcyance, agreements of sate and other-ancillary documents necessary for the absolute solo and disposal of ifte RHO properties, or any part thereof, with such clause or clauses, and agreement or agreements as -the attorney4n 4act shall down proper and o". pedlent, To perform all otheraets necessary to bo done in regard to such powers, as amply and fully to all intents and purposes as the Company could do ifpersonally present; 2. The faoilitation-of the•maintenam of REO properties 0) owned by the Company or (i) servided by the Company for others•pursuant'to an-agreement that authorizes the Company to maintaie.suola RHO.propertles, Including the making of any contract or agreement, that in the, opinion of the attorney-In-W, 1s necessary and proper tb be entered into for the-repair or maintenance of such RHO properties, and pursuant thereto, to execute any and all papers or doeuinenfs pertaining to any vuehrepalr or maintenance and in oonniction with this to do all acts necessary to execute, deliver, acknowledge, file and record such papers or documents when necessary; 3. The facilitation of the collection, demand and other actions necessary or desirable to collect any orall sums o£monoy that may now be or hereafter become due and owing pursuant to rental arrangements of any kind and mortgage ordaazard Insurance contracts or claims when applicable under the relevant state -law when directly related to REO properties (i) owned by the - Company, or (33) serviced by the Company fbr- others pursuant to an agreement that authorizes the Company to dispose ofsuch REO properties; 4. The facilitation of thevvietion- according to state law of occupants ftom RHO properties {i) owned by the tompany or (h) serviced by doe Company for *there pursuant-to an agreement .... blot authorizes tha'.Company.to. dispose of. such ltF.(?.pr4port t -And ............................... 5. The endorsement, cashing, negotiating and dealing with all cheeks, money orders and other forms of payment of any -kind -in connection with the faeilitation of the marketing and disposal of RRO- properties (i) owned by die Company or (li) serviced by the Company for others pursuant to an agreement #hat authorizes the Company to dispose of such RRO properties. The undersigned gives to add attorneys -In -foot flail power and authority to execute such instruments as if the undersigned were personally present, hereby ratifying and confirming that all said attorneys4n4actshall lawfully do or cause to be done by authority hereof. The Company wilt be provided with a written list of the parties who have signatory authority for -the attorney4n -fact and an updated list will be provided to the Company ds is necessary, or I_'`. V, MUTED POWER OF ATTORNEY U RMC Mortgage Corporation (hereinafter the "Company "), a Delaware Corporation with its Principal. place of business located at Lewisville, Texas, constitutes and appoints all3ndividuals With the signatory authority of Regional Vice President, Vice President, Assistant Vice President or abovewho are employees of-Green River Capital Corporation, a Utah Corporation, ad such-other person or persons as any of them shall designate f%om tune to- time,•and each-of them, any. of %vhom•may aot•alone, the true and lawRal attorneys -in -fact of $a Company, with respect to anyreal property interest that-the Company currently has or hereafter may have to do or perform in the name, place and dead and for its use and benefat, to execute, endorse and acknowledge all documents customarily and reasonably necessary and appropriate for the facilitation and the disposal of 12130 properties owned by or serviced by the Company. Such power shall Include„ but not be limited to the follolving; 1. The. #aoilitafion of the marketing and disposal of RBQ propertles.(i) owned by the Company or (ii) serviced by the Company for others-Pursuant to an agreement that authorizes the Company to.dispose of such FM properties, for such price and to suehperson orpersons as the attorney -itt -.tact 'shall deem proper and conveniont, including the oxeeufion, acknowleftentetit, delivery, filing and recordation of*a deed or deeds of convcyance, agreements of sate and other-ancillary documents necessary for the absolute solo and disposal of ifte RHO properties, or any part thereof, with such clause or clauses, and agreement or agreements as -the attorney4n 4act shall down proper and o". pedlent, To perform all otheraets necessary to bo done in regard to such powers, as amply and fully to all intents and purposes as the Company could do ifpersonally present; 2. The faoilitation-of the•maintenam of REO properties 0) owned by the Company or (i) servided by the Company for others•pursuant'to an-agreement that authorizes the Company to maintaie.suola RHO.propertles, Including the making of any contract or agreement, that in the, opinion of the attorney-In-W, 1s necessary and proper tb be entered into for the-repair or maintenance of such RHO properties, and pursuant thereto, to execute any and all papers or doeuinenfs pertaining to any vuehrepalr or maintenance and in oonniction with this to do all acts necessary to execute, deliver, acknowledge, file and record such papers or documents when necessary; 3. The facilitation of the collection, demand and other actions necessary or desirable to collect any orall sums o£monoy that may now be or hereafter become due and owing pursuant to rental arrangements of any kind and mortgage ordaazard Insurance contracts or claims when applicable under the relevant state -law when directly related to REO properties (i) owned by the - Company, or (33) serviced by the Company fbr- others pursuant to an agreement that authorizes the Company to dispose ofsuch REO properties; 4. The facilitation of thevvietion- according to state law of occupants ftom RHO properties {i) owned by the tompany or (h) serviced by doe Company for *there pursuant-to an agreement .... blot authorizes tha'.Company.to. dispose of. such ltF.(?.pr4port t -And ............................... 5. The endorsement, cashing, negotiating and dealing with all cheeks, money orders and other forms of payment of any -kind -in connection with the faeilitation of the marketing and disposal of RRO- properties (i) owned by die Company or (li) serviced by the Company for others pursuant to an agreement #hat authorizes the Company to dispose of such RRO properties. The undersigned gives to add attorneys -In -foot flail power and authority to execute such instruments as if the undersigned were personally present, hereby ratifying and confirming that all said attorneys4n4actshall lawfully do or cause to be done by authority hereof. The Company wilt be provided with a written list of the parties who have signatory authority for -the attorney4n -fact and an updated list will be provided to the Company ds is necessary, or IN WITNESS WfIEREO%', the Company has caused these presents to be signed•in its name by its undersigned officers, and its seai'anxed tills Wh day of UJ LY, „_2007. Attest'_ lan -- 4 wi° --ir .. Name: Ann Lucite Title: Assistant Ssry (Corporate Scat) State Of Texas County of Denton t w, .BMC M TO OB RATION By: G Name.. M�a.rk Blanton ry On this -26 di 2007, before Brie, the understgned, a Notary 1a and f or the S orasaid, personally appeared EMC Mortgage Co Its SIB ECg l'U Dt3N Corporation by by the execution Of the foregoing instrument. -- -- and acknowledged WITNF&S my ha lid. and official-seal. Notary: PAULA M. LL My Colnmission Expires: 4/2 PA� M. t;t;ItLy rY ftworoaa Stzta of Terms �f►a+o�t4•?Art Miami Shores Village 10050 N.E. 2nd Avenue ° Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address Parcel Number Applicant 98 NE 103 Street 1132060131570 Miami Shores, FL 33138 - Block: Lot: DOLORES PARENTE DOLORES PARENTE 98 NE 103 Street MIAMI SHORES FL 33138 -2327 Contractor(s) Phone Cell Phone AMADI ROOFING INC Type of Work: Re Roof Additional Info: COLOR THRU Classification: Residential Fees Due Amount CCF $15.60 Education Surcharge $5.20 Permit Fee - New Roof $350.00 Scanning Fee $15.00 Technology Fee $6.75 Total: $394.55 Valuation: $ 26,000.00 Total Sq Feet: 4233 Total Amt Paid I Amt Due $ 0.00 $ 0.00 Payment Type: C F�dA -SUN 2 ® PAID Available Inspections: Inspection Type: In 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 June 19, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Thursday, June 19, 2008 w Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 07/12008 Permit Type: Roof Inspector: Grande, Claudio Inspection Type: Tin Cap Owner: PARENTE, DOLORES Job Address: 98 103 Street NE Miami Shores, FL 33138- Work Classification: Roof - New Phone Number Parcel Number 1132060131570 Project: <NONE> Block: Lot: Contractor: AMADI ROOFING INC Ruildinn r)anartment Cnmmantc REPLACE TILE ROOF Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Wednesday, July 16, 2008 Page 2 of 2 07/17/2008 16:16 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES ,.Vmf Z)P. W46itestt 10050 NE 2^d Ave Miami Shores, Fl 33138 Phone 305 - 795.2204; Fax 305.756.8972 www.miamishoresvillage.com RE: Pen-nit # DATE: 7 ` l L� C) INSPECTION AFFIDAVIT 2001/001 L �e A- PA C1 ^tJ r � licensed as a (n) Contractor / Engineer 1 Architect, (Print name and circle License Type) FS 468 Building Inspector License #: 0--e—'9C- 5 On or about "/L -0 �� r� �� I did personally inspect the roof deck nailing and /or (Date & time) g _� l !� �-' � / lu secondary water barrier work at 0M e (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above property mentioned. before me this % day of Sworn to and subscribed r PAY M"M PA M �ti c ` = COMMI3,SION A DD 72M Notary Public, Sate of Florida at Large L •�- e=a�uS:0WYPWeru6'2011 'General, Building. Residential; or Roofing Contractors or any individual certified under 468 F.S. to make such an insp Include photographs of each plane of the roof with permit # and address # clearly shown marked on the deck for each inspection .......... Inspection Date: 07/16/2008 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Deck Owner: BOERNER, JEFFREY Work Classification: Pool - Private Job Address: 970012 Avenue NE Miami Shores, FL 33138-2544 Phone Number Project: <NONE> Parcel Number 1132050170010 Block: Lot: Contractor: P&M ELECTRIC INC Phone: (305)949-6373 Buildina Denartment Comments ELECTRICAL WORK FOR NEW POOL 140 Inspector Corrl'_ ns rwr Passed I I DECK BONDING Failed Correction Needed Re-inspection Fee ($75) No Additional Inspections can be scheduled until re-Inspection fee is paid . Tuesday, July 15, 2008 Page 2 of 2 A Inspection Worksheet Miami Shores Village ye yo`Q 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -3"14 Inspection Date: 07/17/2008 Inspector: Devaney, Michael Owner: DUMAS, VERONICA Job Address: 9650 BAYSHORE Drive N Project: Miami Shores Village, FL <NONE> Permit Type: Electrical - Residential Inspection T e: F_-4 "( Work Classification: Addition /Alteration Phone Number Parcel Number 1132060143750 Block: Lot: Contractor: ELOHIM ELECTRIC Phone: 305 - 635 -7999 Buildino Denartment Comments LOW VOLTAGE ow Inspector Comments �� f cc Passed 121 Failed _ C Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Wednesday, July 16, 2008 Page 2 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ::: ' :• :...:::........... .......... .:::. 1�............:......................::::::::::::::::.:: ..:::::::: ::: ::.::::::... ..t ....::.::..::........ ' Inspection Date: 11/07/2008 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Tile In Progress Owner: STERN, DAVID Work Classification: Roof - New Job Address: 98 103 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060131570 Project: <NONE> Block: Lot: Contractor: AMADI ROOFING INC Suildinn Denartment Cemmentc REPLACE TILE ROOF Passed Inspector Comments CREATED AS REINSPECTION FOR INSP-99253. CREATED AS REINSPECTION FOR INSP- 99017. CREATED AS REINSPECTION FOR INSP - 98965. CREATED AS REINSPECTION FOR INSP - 84156. Failed NO LADDER OR PERMIT AT JOBSITE CANCELLED BY CONTRACTOR LEFT MESSAGE ON VM, 10/03/08 REMOVE ALL RIDGE CAP TILE CALL FOR INSPECTION BEFORE STARTING TO RE-INSTALL. JR 11/05/08 Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- insnzction fee is paid . Thursday, November 6, 2008 Page 2 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ::::::..:..:: .::.:::.:::....:.:.:.........................................................:........:..::.:.....:.................................................. ............................... ........ a •' ..:::�::::::.::�:. :....�. Inspection Date: 11/05/2008 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Tile In Progress Owner: STERN, DAVID Work Classification: Roof - New Job Address: 98 103 Street NE Miami Shores, FL 33138- Project: <NONE> ContraCor: AMADI ROOFING INC Buildina Denartment Comments Phone Number Parcel Number 1132060131570 BIM 0 6 2008 Lot: REPLACE TILE ROOF — ® 6 14 A Passed Inspector Comments CREATED AS REINSPECTION FOR INSP 99017. CREATED AS REINSPECTION FOR INSP - 98965. CREATED AS REINSPECTION FOR INSP- 84156. NO LADDER OR PERMIT AT JOBSITE Failed CANCELLED BY CONTRACTOR LEFT MESSAGE ON VM, 10/03/08 �D UE 4- �( �i `T-� �> . Correction Needed ® AD r-v e_ .— `C Ct S ��r✓ 'It D A-) E s I. /Z r&Dc— `TZ� r S Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Wednesday, November 5, 2008 Page 2 of 2 4° Inspection Worksheet one omen Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 11/05/2008 Permit Type: Roof Inspector. Rodriguez, Jorge Inspection Type: Tile In Progress Owner: STERN, DAVID Work Classification: Roof - New Job Address: 98103 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060131570 Project: <NONE> REINSPECTION FOR INSP- 98965. CREATED AS REINSPECTION FOR Block: Lot: Contractor. AMADI ROOFING INC INSP - 84156. NO LADDER OR PERMIT AT JOBSITE Buliding Department Comments REPLACE TILE ROOF Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 99017. CREATED AS REINSPECTION FOR INSP- 98965. CREATED AS REINSPECTION FOR INSP - 84156. NO LADDER OR PERMIT AT JOBSITE Failed El CANCELLED BY CONTRACTOR LEFT MESSAGE ON VM, 10/03/08 Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, November 4, 2008 Page 1 of 2 lei Inspection Worksheet Miami Shores Village 10060 N.E. 2nd Avenue Miami Shores, FL Phone: (306)795-2204 Fax: (305)766-8972 W (0) a F69Z Inspection Date: 10/31/2008 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Final Owner: STERN, DAVID Work Classification: Hurricane Mitigation Job Address: 98 103 Street NE Miami Shores, FL 33138- Project: <NONE> Phone Number Parcel Number 1132060131570 Block: Lot: Contractor: OCEAN BLUE CONTRACTORS INC Phone: (305)234-6065 Buildina Denartment Comments I Passed El Inspector Comments PP Failed 19 Correction Needed Re-inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Thursday, October 30, 2008 Page 1 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 10131/2008 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Tile In Progress Owner: STERN, DAVID Work Classification: Roof - New Job Address: 98 103 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: AMADI ROOFING INC Building Donartment Commonfiq Block: Phone Number Parcel Number 1132060131570 Lot: REPLACE TILE ROOF v. Inspector Comments Passed ❑ ��, Iza� c b 1, rt -����' . Failed Correction Needed Re-inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Thursday, October 30, 2008 Page 1 of 2 Inspection Date: 11/12/2008 Inspector: Rodriguez, Jorge Owner: STERN, DAVID Job Address: 98 103 Street NIF Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Project: <NONE> IAMN Contractor: AMADI ROOFING INC Building Department Comments Permit Type: Roof Inspection Type: Hot Mop Work Classification: Roof - New Phone Number Parcel Number 1132060131570 Lot: REPLACE TILE ROOF NN 1 13 2000 Inspector Comments Passed N C) T: r— a Av Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Monday, November 10, 2008 Page 1 of 2 -;�OS3 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque�st������ -�'� Date ZZ Type Insp' n �� f n Permit No. �® `4 -(010 Name 1(2 Tr im A Address 01 0 WE 103 5 Company -0w op✓ Phone # Inspection Date Approved Correction ❑ MIAMI SORES VILA. iGE BUILDIN EPARTMENT 305 -795 i�04 " Building Inspection Request Date z -z Type Insp'n Permit No. 10 1-�^ Name ` � 1 1- Address q Y Company owaey r Phone # Inspection Date 77123 Approved Correction ❑ Re -Insp' n Fee 71 Re -Insp' n Fee 71 Inspection Date: 11/10/2008 Inspector: Rodriguez, Jorge Owner: STERN, DAVID Job Address: 98 103 Street NE Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Project: <NONE> Block: Contractor: AMADI ROOFING INC Building Denartment Cnmmpntc Permit Type: Roof Inspection Type: Tile In Progress Work Classification: Roof - New Phone Number Parcel Number Lot: 1132060131570 REPLACE TILE ROOF Inspector Comments Passed -I "� 11-1,5;' -,,- Failed E]_ Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Friday, November 7, 2008 Page 1 of 2 r 1 t r r r r r r r r r r r r r r r r r r r r r r. r r r r r r t r r CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION NOO 1930 Miami S1 Owner, Agent or Tenant of Building Lot I -t Block i Z Street Address q I N, , �- . 0 Approved use by Remarks: This Certificate of Occupancy is issued to the above named �► for building at above named location only upon the express provision, that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or r odeling of buildings or structures. ���''s 7,4 v BUILDING DIVISION Inspection Date: 10/3112008 Inspector: Rodriguez, Jorge Owner: STERN, DAVID Job Address: 98 103 Street NE Miami Shores, FL 33138- Project: <NONE> Permit Type: Roof Inspection Type: PE Certification Letter Work Classification: Hurricane Mitigation Block: Phone Number Parcel Number 1132060131570 Lot: Contractor: OCEAN BLUE CONTRACTORS INC Phone: (305)234 -6065 Buildina Deoartment Comments Thursday, October 30, 2008 Page 1 of 2 Passed El Inspector Comments 1\10 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Thursday, October 30, 2008 Page 1 of 2 { hits CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION NO 446 Miami Shores Village, Florida, JM1 Y 1s 1957 Owner, Agent or Tenant of Building John Phaiff Lot 1 -2 Block. 12 Subdivision Ni =i Shores Sec, #1 Street Address 98 No E. 103rd St. Approved use by occupancy Jalousie Porch Additon Remarks: This Certificate of Occupancy is issued to the above named owner for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the- erection, construction, alteration or remodeling of buildings or structures Plan Cube 4048 Tax Value 2024 //`B'UILDING DIVISION _. THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE A Penalty is imposed for failure to keep this license exhibited at your establishment or place of business 1f. • U.• •" f Xf. if lf•••'•••If. 1f !f.•••.• Zf.•• ° "••if, 1f.� 1f If. If. a>r_�y —,t ••• f ,••� ` icpT4�` tti�1C1D�4�iiC 7�Oit {��t,'G�� '�'ti��ic '� 1. TRIPLICATE VIL �~ r.' ^ : I VILLAult, •�, s r This License Expires 24,199 N? 5326 ~ In consideratioo of the sum of E Oft, - Dollars $ {¢ Paid to Miami Shores Village, Dade County, State of Flori Address. ~"- i is hereby licensed to engage in or operate the business of "W st For the period beginnin 240606W 44 3,953 and ending s �• G subject to the Provisions of all ordinances. H G MIAMI SHORES VILLAGE, FLORIDA (SEAL)s !' ti Issued u Late VILLAGE MANAGER �• THIS LICENSE NOT TRANSFERABLE WITHOUT APPROVAL OF THE VILLAGE MANAGER ? . OWNER'S NAME PRESENT ADDRESS - LICENSE IQC ?''(`'PHONE NO.+ TF)hn Pinaife I ' JOB LOCATION (ST. OR AVE.) LOT - BLOCK SUBDIVISION a8 N.& 103rd Street I 1 -2 ( 12 I' Sec. 1 GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO.. )T,jmer I I I BOND I 20.00 /BUILDER'S I 1601 BUILDING PERMIT NO. 1.5209 DATE 9_21 _1;1 PERMIT FEE $ NO. DATE I 1:'250 16,000 ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT, . EST. COST $ DATE DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION c I CBS I 11 I tile oak floors, plaster walls and NEW CONSTRUCTION DESCR IPTION ceilin gs I I 3 baths -3 bdrms.- la, room - living room - kitchen- dining room - garage REPAIRS DESCRIPTION ALTERATION ADDITION APPROVED REJECTED (REFERRED TO COUNCIL I REASONS SUBMITTED TO PLANNING BOARD RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUNCIL '�"�''�✓ " CERTIFICATE OF OCCUPANCY NO. ISSUED �-;'/ BY F�''G" TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE BUILDING INSPECTIONS.` INSPECTIONS DATE BY RE- INSPEC BY RE-INSPECT BY FOUNDATION REPAIRS ._ :SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE BEAMS &LINTELS t H. W. HEATER CONN. $ SEPTIC TANK $ FRAMING SEWER $ MOTORS $ SOLAR HEATER $ FIXTURES $ GAS FINAL •I`- ,., INSPECTIONS CLEAN -UP f DATE BY RE- INSPEC BY RE-INSPEC7 a a I I51ci 10 Cal U y-j ,,I YY- -Wzm is "7 =i iT� CONTRACTOR �� PHONE PERMIT NO. S` �� DATE O - �"^ F `.7 FEE S NEW BLDG. ALTERATION ADDITION REPAIRS ._ :SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ SEPTIC TANK $ RANGE CONN. SEWER $ MOTORS $ SOLAR HEATER $ FIXTURES $ GAS $ $ INSPECTIONS DATE INSPECTIONS DATE BY RE- INSPEC BY RE-INSPEC7 BY ROUGHING 6 ROUGHING ' ri �•�, GAS L H. W. HEATER CONN. SEWER RANGE CONN. SEPTIC TANK .. `yu.• E SOLAR HEATER FIXTURES & FINAL FIXTURE S° -' t ELECTRICAL PFRMITS R iNCPFCT1AlUf4 CONTRACTOR PHONE PERMIT NO. "` {�`,' DATE FEE $= t'es+�j° NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ INSPECTIONS DATE BY REANSPEC BY RE-INSPECI BY TEMP. SERVICE 6 ROUGHING ' ri �•�, '-- L H. W. HEATER CONN. RANGE CONN. FIXTURES & FINAL "+ -' APPROVAL TO POWER CO. F R SERVICE RVICE DATE BY 4 n'). T, C'a - - OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHONE NO. �I p hJ �y,� I I JOB LOCATION (ST. OR AVE.) LOT BLOCK SUBDIVISION M N.E. 103rd Street ! 1 -2 I 12 I See. 1 GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE:NO. owner I I BUILDER'S BOND 2511 10 -5 -55 7.00 1857 BUILDING PERMIT NO. DATE PERMIT FEE $ff}� NO. DATE I 4$O /+a 500 ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COST $2jp DATE DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: TYPE I STORIES I ROOF CONSTRUCTION INTERIOR CONSTRUCTION NEW CONSTRUCTION DESCRIPTION Jalousie Porch Addn. REPAIRS DESCRIPTION ALTERATION ADDITION APPROVED REJECTED (REFERRED TO COUNCIL I REASONS ' SUBMITTED TO PLANNING BOARD I RE- SUBMITTED TO PLANNING BOARD - REMARKS SUBMITTED TO VILLAGE COUNCIL I CERTIFICATE OF OCCUPANCY NO. ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI bHVHt, VILLAur- BUILDING INSPECTIONS V c - 7,XN'°r INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION DATE Kv TEMPORARY SERVICE $ .BEAMS & LINTELS $ SEWER 'FRAMING SOLAR HEATER $ GAS $ $ INSPECTIONS F1 NAL BY RE- INSPECT BY RE- INSPECT BY ROUGHING CLEAN -UP ` PLUMBING PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. DATE FEE -$ NEW BLDG. ALTERATION ADDITION REPAIRS ESPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK $ SEWER g5 SOLAR HEATER $ GAS $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING GAS SEWER SEPTIC TANK SOLAR HEATER FIXTURES ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL APPROy.AL TO POWER CO. FOR SERVICE DATE BY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE ELECTRICAL ❑ PERMIT N° 15935 Contractor's PLUMBING ❑ License No. 110017ING ❑ Work to be performed under this Permit Owner of Architect - ontractor or Builder Legal Lot I) Bl. Subdi- vision 95 Address of II Value of I Amt. of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: _ BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Architect _ - ontractor or Builder Legal Lot Descrintion MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT® ? ��f�[l Work to be performed under this Bl. 195 Subdi- vision Address of II Value of Amt. of Building _ Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner Buildin Architei -ontrac or Builc Legal Descript Address Building MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 195 ❑ PERMIT N® 15340 Contractor's ❑ License No. _ ❑ Work to be performed under this Permit _ of a for er Lot II ion. BI, Subdi- vision of --1 /,i/� r Value of Project $ Amt. Permit of $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SH13RES VILLAGE, FLORIDA BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT N? 15474 Contractor's PLUMBING, ❑ License No. -- - -- _ ROOFING ❑ Work to be performed under this Permit _ _ -_ - --_ __ Owner Buildin Archite - ontrac or Build Legal Descrip Address Buildin of ct — tor er Lot II Bl, Suhdi- tion. I vision of Value of Amt, of q Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT Na 15307 Contractor's PLUMBING ❑ License No. ROOFING ❑ Work to be performed under this Permit__ -- — Owner of Building Architect — e, ontractor or Builder Legal Lot II Bi, Subdi- Description _ vision Address of Value of Amt. of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application berefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ 15284 DATE ELECTRICAL ❑ PERMIT -��I �T ? Contractor's PLUMBING ❑ License No._ ROOFING ❑ Work to be performed under this Permit _ Owner Buildin Archite ontrac or Build Legal Descrip Addres s Buildin g 195 of cl _ ct for er Lot II Bl, Subdi- tion, vision Of / Value of Amt. 'y Project $ Permit of $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA MILDING ❑ MECTRICAL ❑ PERMIT N? 6 615 MUMBING ❑ IOOFING ._ ❑ ❑ Work to he performed under this Jwner of 3uilding krchitect , ontractor )r Builder _ �egal Description Lot FIN DATE 195 Contractor's , License No. Subdi- vision ress of ''� Value of Amount of ling Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work by his agents, servants or employees, � f Signed: 9 BY: — INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- Zg this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 6 BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Lot Description —_ MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 2'785 r fir. a.. - %� B1 Work to be performed under this Permit Address of Building U _ DATE. / / - 136 1 Contractor's License No. Subdi- vision Value of ' ;:fir ! Amount of 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 a herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with a drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoke 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 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and r( pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility done by his agents, servants or employees. Signed: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and r pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miamf Shores Villa( cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. j CONTRACTOR OR BUILDER BY -_ -- - - AUTHORITY�-- BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ MIAMI SHORES VILLAGE. FLORIDA DATE ' 195 PERMIT N° 5662 Contractor's License No. ❑ Work to be performed under this Owner of Building 1 t�` Architect Contractor �•�+ or Builder .rte.•.__.._ >.. ._,i t,._� C Legal Lot Subdi- Description � � � Bl. _ vision ddress of V of `_ Amount of uilding s,1 Project $ j Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any ime if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A furth ®r condition upon which this permit is ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough kAowledge of the ordinances and regulations ertaining to the work covered hereby whether shown on the plans or drawings or in the statements ,or speci 'cations Qd that he assumes responsibility for work one by his agents, servants or employees. r $ , Permit INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work c6/.red hereunder in compliance with all ordinances and regulations ling thereto and in strict conformity with the plans, drawings, statements or specifica#�pns submitted to the proper authorities of Miami Shores Village. In ac- t this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING (- ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building Architect _ Contractor or Builder. Legal Description Lot MIAMI SHORES li 1`Y VILLR�IDA 5 Ai, 2 511 Contracto? j4'� License No. Work to be performed under this Permit Bl. Subdi- vision Address of Value of j Amount of Building — Project $ Permit $_ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: _ BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY u v AUTHORITY a- BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ EJ MIAMI SHORES VILLAGE, FLORIDA ,r DATE. 19 PERMIT N° 3961 Contractor's License No. Owner of Building 4' Work to be performed under this Permit Architect Contractor or Builder Legal Lot Description Bl. Subdi- vision Address of Value of Amount of Building Project �— ' �I Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY I AUTHORITY ABBOT PRINT 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 2004 Permit Type (circle) Electrical .- A Owner's Name (Fee �r« 1i 498 -- ----- - - - --- •ter_ -- Permit No. r a - m Master Permit No. Plumbing Mechanical oofine Phone 4 O Mr s Addres C State l Zip Tenant/Lessee Name_ "b/1 Phone # Job Address (where the work is being done) City Miam FOLIO / PARCEL # Is Building Historically Designated YES C- r County Miami -Dade Zip 1551 Contractor's Company Name Conrct'' Is Addresys % City�t l State Qualifier I Name at , -q, State Certificate or Registration No. �' Architect/Engineer's Name (if applicable) 1� Value of Work For this Permit $ 25 NO —X Phone # cam` u,-P, 14 _Zip_ Phone # Certificate of Competency No. Phone # Square / Linear Footage Of Work: 4 055 5 U Type of Work: ❑Addition ❑Alteration ew _ >� epair/Replace El Demolition Submittal Fee $ Permit Fee $ SD CCF $ 2� CO /CC Notary $ Training/Education Fee $ 5. (Zo Technology Fee $ Scanning $ IY(VIC), — Radon $ DPBR $ Zoning $ Bond Structural Review. $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 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 Zip City State Zip inspection will not be approved and a reinspection fee will be charged. Signa e Signature 4Z44XX� e—,111 amen River Csr "Attorney in Fact Contractor The foregoing instrument was acknowledged before me this t The foregoing tstrum ent was acknowledged before me this day of �� 20 , by °;�� ` ,� day of f- • , 20 d 8, by ,Q . �• �%� , who is personally known to me or who has produced who is personally known tome or who has produced��t± As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: A �.��''aev'6 311 D Sign 4t_ ti Sign: A o.�... MYCO MMiPrint: S Sf ON :D 72G9&0 Print: e -e suet My Commission Expires: ( > L'`~ My Co s ;3 iiaed T" Notary r�uar ; u. �e ae :, ;, APPLICATION APPROVED BY: /N� &116108 Plans Examiner Engineer Zoning (Revised 07/10/07) APPLICATION APPROVED BY: �e `6 loo8 Plans Examiner i Engineer Zoning (Revised 02/08/06) 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 2004 JUN 17 2008 BY: ----------------- Permit No. rf az l M Master Permit No� Permit Type (circle): Building Electrical M Plumbing Mechanical Owner's Name (Fee Simple Titleholder) Phone # Owner's Address �2_ ( S S City _L e u l VV-e- State ! ��C Zip �7 j b Tenant/Lessee Name_ /a Phone # f�xz x)- Job Address (where the work is being done) 76 A( -Z:F . l 6) S ,�- City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # 1 % - -2) -�, _ 0 �O 0 ) 3 15 --,> cD Is Building Historically Designated YES NO Roofing Contractor's Company Name 00- If 64�/ /` 4e e 0'1 '42'� � p� -7 kone # 3 o c-- �- 3 q - 6O U `o L Contractor's Address ! ®! L/V 5.1w. / & G Te'102 2 City wl i� 4o-�,2 i State 6" Zip 3 S Qualifier Name 'y �1( , e_1 0 e- -s O Phone # -3e- S - 3 q D State Certificate or Registration No. C- / S 0 7 L/ 1� 3 Certificate of Competency No. Architect /Engineer's Name (if applicable) y e 0 Value of Work For this Permit $ j-L - Phone # Square / Linear Footage Of Work: Type of Work: ❑lA-,-d�dition ❑Alteration ONew > Repair/Replace El Demolition Describe Work: l'� O O ' -4- © ( C` a� r\,) .0 9- 0-4 1 h d `� 2 t2 �' C n+ :e_ V117 d Submittal Fee $ Permit Fee $ C) 0 �� ' CCF $ CO /CC Notary S Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Structural Review. $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that.no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 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 Plans Examiner Engineer Zoning 11111111111111111111111111l MIAMI SHORES IAIIIIbIIIIIdNII��III�gVIIIQIInNbIlRlll�ll��l� ADDRESS k PERMIT APPLICATION Master Permit No. Subsidiary Permit Nn� 7 vZ�%DoZ ��ORIDA J Step 1. Complete the attached permit application which must be signed by property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the competed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: Address Apt. City State Zip Folio Number =fir' " `:� / �`' Description of Work o Lot Block Subdivision PB PG Zoning Linear Feet 4t Current Use of Property Square Feet Units Floors Proposed Use of Property Value of Work C2 + Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE ( ✓ ) Electrical Mechanical Fence Other ARCHITECT Name License No. Address Telephone Fax PERMIT CHANGE (✓ ) Ch g. Contractor Renewal Revision Extension PROPERTY OWNER New Construction 1n&80-4*'0 Enclosure dress s Alteration Exterior Home Telephone Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT ✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'1 Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 PERMIT APPLICATION 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. 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. 1, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, I" 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 Ch si-Aa a Contractor. OF MIAMI -DADS Print Name S� too d subscribed before me th13_� day of /i)P% d'1� n ,. r+ ure orNot#ry Public - n O I iAt NOTARY suwc my MJGg6A M BECKER IT try, 00MMISMON SEAL: W)rf C7$6697EW tai`s COMMISSION EXPIRE' fir � NC)V, 15,2002 Personally known OR, Produced Identification(__ Type of Identification ProducedR-1)4 �( V(7, 0 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known Type of Identification Produced: OR, Produced Identification Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE QTY. Service Repair A/C Central 1-3 Ton Fan Outlet, Wall Drinking Fountain Service, Temporary Dryer Vents, Number of A/C Central 4 -7 Ton Fire Pump Outlet, Switch Air Handler, Tons Signs Piping, Flammable Liquid A/C Central 8 -15 Ton Fixture - Fluorescent Oven Fire Sprinkler System Space Heater (kw) Cap - Fixture A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Pressure Vessel Spas/Hot Tubs Sprinkler System A/C Central 20+ Ton A/C Window Flood Lights FPL - Load Central Plugmold/Strip Posts Gas - Appliance Subfeeds, No. of Amps Swim Pool, Commercial Pump, Domestic Air Conditioners Garbage Disposal Range/Range Top Cap - Sewer Swim Pool, Residential Gas - Natural Chiller Generators, etc. Receptacles Temporary Toilet Switchboards Catch Basin Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Pump, Re- circulate Temp Serv., Construction Temporary Water Closet Compactor Low -volt, Burglar Refrigerator, Domestic Gas Piping Temp for Test - 30 days Pump, Replace - Pool Deep Freezer Low -volt, Fire Renew - Temp Service Dental Chair Grease Trap Demolition Low -volt, Intercom/Teleph. Repair Circuits Utility - Sewer Discharge Well Dishwasher Low -volt, Television Service, Number of Amps Pump, Sump Utility - Water MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost Drinking Fountain A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Pool Piping Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Sprinkler System PLUMBING TYPE QTY. A/C Condensate TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE QT Soakage Pit Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re-pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply RECEIVED AND REVIEWED BY: DATE: Page 4 PERMIT APPLICATION OFFICE USE ONLY , CHECKLIST ❑ OWNER -BUILDER FORM ❑ PROOF OF OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) (Attach) ❑ FIRE DEPARTMENT ❑ HRS / DERM APPROVAL ❑ BPR APPROVAL (Restaurants) APPROVAL (Commercial / (Septic / Sewer) multi- family) ❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION (New Construction) (New Construction) (On File) ❑ OTHER ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) $ Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review REVIEWED AND PREPARED BY. (Specify & Attach) $ ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ SECTION BY DATE, Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official (¢.01 /sq.ft.) TOTAL $ ��_60 DATE: Revised July 2001 10050 N.E. 2- AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com - Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BU L15NU Permit No. PE _ ATION Master Permit No. FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) %Er.�//' 1//J %/yOlt4hone # Owner's Address b24-0 6-- — 3 ( s City /�,�.�'% State Zip 2 Tenant/Lessee Names 135571�z Phone # Job Address (where the work is being done)( S� City Miami Shores Village County Miami - Dade ._ Zip 33 Is Building Historically Designated YES NO Contractor's Company Name lylle— Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit � Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: /v T Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $, Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ `l Total Fee Now Due $ (Continued on opposite side) Structural Plan Review. $ 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 inspection which occurs seven (7) days after the building permit is issued. In the absence of such parted notice, the inspection will not be proved and a reinspection fee will be charged. Signature _r__..__ ..._..__ Signature Owner or Agent T o going instrument was acknowledged before me this day of 200 . by who is personally known tto me or who has produced 2__ OD , , 00— s identificatigu_aud who did take an oath. NOTARY Sign: Prim My Commission Expires: State Certificate or Registration No. Contractor The foregoing instrument was acknowledged before me this day of , 20 ___, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: (Certificate of Competency Holder) Certificate of Competency No. APPLICATION APPROVED BY: Chc 12/15/03 MAY 1 1200 Plans Examiner Engineer Zoning ( i. .._� � i ` � ^� , � � � ���� i 1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE .Date lot) Address )Nf /l` le .3 .S / Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee I Tenant /ylt'f�'I S VA /c/ Master Permit # Owner's Address Contracting Co. Address Qualifier SS# - State # Architect/Engineer Bonding Company Mortgagor Municipal # Competency # Address Address Address Phone 3 OX -At-/ •- J-4_94 '- Phone Ins. Co. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTIONY. ^1+'00 % PI-1 i /v"l— Square Ft. Estimated Cost (value WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR Il!"ROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date Notary as to Con My Commission Expires: My Commission FEES: PERMIT RADON C.C.F. NOTARY APPROVED: Zoning Mechanical ract O,w�rer " S 8yz, Date Date E ires: GLADYSS I.AE N(7i'pRY P SPATE OF RMMA MN NO. CC714103 MY EOMMlSS10N E7tP. MAIi 1 BOND 'RMft APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date Job Address `C �0 Tax Folio ..�6 low Legal Description T �, 6� �i Master Permit # �V_�W Owner / Lessee / Tenant Owner's Address Phone Contracting Co. _ Address _129-Y- �(% Qualifier �%�f `" �`'%( SS# - -� Phone p Stated !FJ7,�U-Comp etency# Ins. Co T- Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION BUILDING Address Address Address ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN li+ a//,e & Ft. �'� r Estimated WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the ab ve -named contractor to do the work stated. Signature Owner and /or 'CA-do Presid nt Sign ture of Contractor or Owner - Builder Date: Da Notary a0loto Owner andfor ConPresid N ary 4s to Contractor og Owner - Builder Fl Comm ssio ,' Fly #lel�y�i�ii, =�4We of I�orcdot My Commission Expires: * * W1 C ' Eapi% Sept. 24,ft94 iiw T Pan • i $w"" b& PERMIT FEE: PPR�VED: -1 Fire Other T Zoning wilding%- 12,E j 5 T Mechanical Plumbing Electrical Engineering _ PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date iS i3 Job Address 5,6 AIC fy3 Sr— Tax Folio // Legal Description ICY 01 / % #AwvMaster Permit # t!'r-) Lessee / Tenant Owner's Address_ Phone Contracting Co.�,;�c �cz �G r�X3i. �°c��', Address Qualifier L - CyLL Tr2, SS# ?. `> - � - _ Phone c State G'f rU i 5 � �t` Competency 46 ` -� , ; ; Ins. Co. Architect /Engineer Address Bonding Company Address Mortgagor Permit Type (circle one): BUILDING WORK DESCRIPTION Address ELECTRICAL PLUMBfNG MECHANICAL PAVING FENCE SIGN Square Ft. Estimated Cost WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: PERMIT FEE: APPROVED: Fire Sign ure of Co ractor or Owner-Build-or Date.- 1� / /. - Notary s to Contractor or Oyner- Builder My Commission Expires:`�'j Zoning Building '�% �r 'Mechanical Plumbing T �t Other Electrical Engineering