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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: 12/07/2006 Inspector: Grande, Claudio Owner: Job Address: 401 103 Street NE Miami Shores Village, FL Project: <NONE> Contractor: Permit Type: Residential Construction Inspection Type: Re Occupancy Work Classification: Re- Occupancy Block: Phone Number Parcel Number 1122310150130 Lot: Building Department Comments -50-s ---- - g CAI- • tic • Passed Failed Inspector Comments DEC 0 8 SI Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. tio Tuesday, December 5, 2006 Page 1 of 2 Miami Shores Village Building Department RE- OCCUPANCY APPLICATION I Date 12. c 1®6 Contact Name ��� -.�c� Q Phone # 3c��' ctoei C)� Buyer Seller Realtor Company Name 10050 N E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 Permit No. G2 - b Loc ID Property Address LI O 1 L) b S - City Miami Shores State Fl Zip 3 3 ( 3 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. v j a -S Applicant Nam Signature The foregoing instrument was acknowledged before me this day of i 20 C)1.40 r . I n by CQ AN, 'V\ , who s personally known to me or who has produced • as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: \A L LOIS E. LIMEY MY COMMISSION 8 DD 381851 EXPIRES: December 15 2008 Bondetl thtuNtfmtyPeelleUndenwiters Building Officials Approval: - -' Rev. 10/02/03) Re -Occ. $60.00 Notary $5.00 CCF Total Page 4 PERMIT APPLICATION OPFICEUSE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New. Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL • (Septic / Sewer) ❑ IMPACT )~'EE (New Construction).- ❑ OTHER" (Specify & Attach) • CONDO ASSOCIAATIO N APPROVAL (Attach). Si 'y ❑ BPR APPROVAL (Restaurants) CONTRACTOR REGISTRATION (On -File) PERMIT FEES $3.09 per page (Scanning Miami Shores Village - Bond Metropolitan Dade County _(C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review (sq.ft. = x/I000 x 0.60)' (0.005 /sq.ft.) TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARE]) BY: DATE: SECTION BY DATE Zoning Electrical: Mechanical Plumbing Fire Public Works Structural Building Official CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION Masten Permit .No. Subsidiary Permit No. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the atrarhed permit application which print or type to allow for a more accurate processing along with this permit application. must be signed by the property owner and qualifier. Both signatures must be notarized. Please of your application. If roofing work will be done, a roofing application must be submitted Step 2. $ubmit the completed application with all necessary processing of your application,. you may be asked to Job Address: SO/ Address Folio Number" 2231 /E (0 3 documents to the Building, Planning and Zoning Department for processing. During the submit additional information. Apt. Lot Subdivision Block PB 5 ,�'�, ZAIJ City State Zip Description of Work ,As. Zoning Current Use of Property Square Feet Proposed Use of Property Valve of Work 2-5-41r4= Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Linear Feet Units Floors PERMIT TYPE (✓ ) Building Electrical Mechanical - Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension _ Supplement Reinspection .ARCHITECT .Name License No. Address Telephone Fax PROPERTY OWNER Name Address 9 flame Telephone Business Telephone TYPE OF MANAGEMENT (1) New Construction License No. Enclosure Telephone Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure _ Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTO1 C Name Cie:o,dfid License No. $'.� /e'`p Address �� /1/ •_ Lai * . Telephone C.S1 ziS7 ' d 661-7 f - Qualiller Name e;: Page 2 PERMIT APPLICATION Page 3 PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit 6. PORTABLE TOILETS for a construction site require a separate permit 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section'713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. RipA OF MIAMI-DADE ignature of Owner t E C 1 kY co Print Name / \ Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification STATE OF FL A, COUNTY OF MIAMI-DADE Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. 11Tinimum Fee A/C Central 1 -3 Ton - Paint Booth Fan Air Handler, Tons Outlet, Wall Piping, Flammable Liquid Service, Temporary Barbecue A/C Central 4-7 Ton Piping Fire Pump _ Outlet, Switch - Pressure Vessel Signs Cap - Fixture A/C Central 8-15 Ton Fountain Fixture - Fluorescent Pump and Abandon Oven Sprinkler System Space Heater (kw) Cap - Water A/C Central 16.20 Ton Gas - Appliance Fixture Light-- Pump, Domestic Parking Lot Lights Supply, AC Well Spas/Hot Tubs Cap - Sewer A/C Central 20+ Ton Gas - Natural Flood Lights Pump, Fire Stand Plugmold/Strip Temporary Toilet Subfeeds, No. of Amps Catch Basin A/C Window Gas - Propane FPL - Load Central Pump, Re- circulate Posts Temporary Water Closet Swim Pool, Commercial Clothes Washer Air Conditioners Gas Piping Garbage Disposal Pump, Replace - Pool Range/Range Top Urinal Swim Pool, Residential Dental Chair Chiller Grease Trap Generators, etc. Pump, Sprinkler Receptacles Utility - Sewer Switchboards Discharge Well Clear Violations Ice Maker Heat Recovery, . Pump, Sump Refrigerator, Comm. (p/PH) Utility - Water Temp Serv., Construction Dishwasher Compactor Indirect Wastes Low -volt, Burggar Relay Repair Refrigerator, Domestic. Vacuum Pump Temp for Test - 30 days Deep Freezer Interceptor • - ' Low -volt, Fire ` Roof Inlet Renew - Temp Service Water Closet Domestic Well Demolition Laundry Tray Low -volt, Intercom/Teleph. Septic Connection Repair Circuits Water Heater Drainfield, 4" Tile/Res. Dishwasher Lavatory Low -volt, Televis`ion Septic Tank Service, Number of Amps Water Heater New Drains, Area MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain Q'I'Y. TYI'E, Generator QTY. TYPE: QTY. Refrigeration, Tons A/C Central, Tons - Cooling Tower - Heating Strips, each - Vent Hood, Cost A/C Wall/Wm. Tons - Dryer Vents, Number of - Paint Booth - Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid - Periodic Inspections--- ME Barbecue - Fire Sprinkler System Piping Bath Fan - Vented, # - Fireplaces, Number of - Pressure Vessel PLUMBING TYPE A/C Condensate QTY. TYPE: Drains, Roof QTY. TYPE; Miscellaneous Fixture QTY. "111'E Soakage Pit Q Y. 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 - 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: y1?,`� SI No EXISTING STRUCTURE TENSION FASTENER EXISTING STRUCTURE 'P EDGE DIV. (SEC ANCHOR SCFEMILE) TENSION FASTENER CSEE ANCHOR SCHEDULE) EXISTING STRUCTURE 4 c 4' MAX. 1/4 -20 MACHINE BOLT L VINGNUT a 6.3' O.C. CTYP. TOP L BOTTOM) 1/4•0 RAVI. CALK -IN e 6 -1/2' GG V/ 7/U' OR EMBEDNE CT IN CONCRETE EXISTING STRUCTURE • A • 4* • M GLASS OR DOOR GLASS OR DOOR --- GLASS OR DOOR 0 CONT. 1/4 -20 MACHINE SOL.T I. VINGNUT R 63' DC. GLASS OR DOOR — EXISTING STRUCTURE 0 CONT. (TYP. TOP L BUTTON 4 4 4 V4 -20 MAOHOE BOLT L NUT TENSION OSOiEDULD R CTYP. TOP I. ammo CSEE TENER tSEE A NOER SOEI LtD 1/4-20 MACHINE BOLT L WINONUT R 65' OZ. TYP. TOP L BOTTOM EDGE 01ST.. A e '- CSEE SHEAR SCI-E1XXD ® CONT. - TYP. TOP L BOTTOM PRODUCT RENEWED /� ACCEPTANCE No. "I ri -62) z.6 62 EXISTING STRUCTURE • ANGLE TO WALL DETAIL PANEL TO ANGLE DETAIL O WALL MOUNT SECTION SCALE ' 1/4's 0•- 1' VCtOD FRAMING SEC AtCHOR SO LD MIN. GLASS OR DOOR 0 CUNT. WOOD FRAMING ANGLE TO WALL DETAIL GLASS CR DOOR CEILING /INSIDE MOUNT SECTION SCALE r 1/4' At Cr- 1' PAJ.CL TO ANGLE DETAIL WALL MOUNT SECTION SCALE ► 1/4' = 0'- 1' PLYVO)D AND STUCCO FINISH MAXIMUM PANEL LENGTH o 101' ® CONT. 114'0 x 1 -3/4' S.S. LAG B 12' QC. V/ I -I/2' PENETRATION INTO VOID 2- I/4'Ox4- V2'IS. LAG SCREW a 24' Or- MAX. V/ 1-3/4' PENETRATION IN CENTER OF STUDS 2' x 6' P.T. WOOD FONT. Nf1TF. WOOD BUILD -IXlT CONNECTION NAY BE USED AT TOP USING 'h' HEADER ®AS SHOWN IN WALL SECTION O . WALL MOUNT SECTION (BOTTOM) - SCALE ' 3' = .1'-0' EXISTING STRUCTURE s SIDE CLOSURE REO'A .CSEE PLAN VIEW B'_,ILD -GUT MOUNT SECTION SCALE s 1/4' = 0' -1' EXPIRATION DATE BY PR D • CONTROLD #4 •N BUILD I • CODE COMPLIAN •FFICE O DIRECT MOUNT SECTION SCALE I.3'* ANCHOR runs. L FIL OR STUCCO. 2. . FRAMING. FASTENER VOEIL STUD. 3. • Arc -zis SHALL BE AND EDGE DISTANCE EXCLUDES WALL FASTEN TO NARROW FACE OF STUD SHALL BE LOCATED IN CENTER OF A. INSTALLED IN ACCORDANCE "ITN ING WITH THE SOUTH FLORIDA BUILDING CODE DA Br PRODUCI CONTROL DIYIS1ON. BUILDING CODE ,OMPLIANCE OFFICE ACCEPTANCE NO `i� if (S' t %3 PROFESSIONAL ENGINEE FI. L. e No: PE 0010983 JAN 2 6 i995 Orate C 0 r 0. L U a S B 5 DIRECT MOUNT ADDITION 9 0 a G W < d N. drnwing no- 94-98.1 ..hrv2 P FASTENER • ANCHOR SCHEDULE • 0.'C.) FASTENER SPACING REQUIRED CINCHES O.C.) '2c:iill "'"1 ANC}(R DCSCRUPTION SPACING REQUIRED CINCHES 1/4'• LTV TAPCON ANCHOR .W/ 1 -1/4' MIN. EMBEDMENT EXISTING STRUCTURE - CONCRETE HOOD FRAMING ANCHOR DESCRIPTION 1/4'0 RAVL CALK -IN, V/ 7 /B. MIN. EMBEDNENT 1/4'0 ITV TAPCEDN ANCHOR V/ 1 -1/4" MIN: EMBEDMENT I/4'0 U.S. SLEEVE ANCHOR IV C' MIN. EMBEDMENT ONE 1/4'4 WOOD LAG SCREW V/ 1 -7/8' MIN. EMBEDMENT EDGE ST. 'SPAN CL) FT. r 1 IC �. 2• Y 2' :,...;-"...--r.'"--3' 3/4' 1 cSEE AMOUR N3TE No. 2) L f teI• I0• O. p. O. 12• 13' ANCHOR runs. L FIL OR STUCCO. 2. . FRAMING. FASTENER VOEIL STUD. 3. • Arc -zis SHALL BE AND EDGE DISTANCE EXCLUDES WALL FASTEN TO NARROW FACE OF STUD SHALL BE LOCATED IN CENTER OF A. INSTALLED IN ACCORDANCE "ITN ING WITH THE SOUTH FLORIDA BUILDING CODE DA Br PRODUCI CONTROL DIYIS1ON. BUILDING CODE ,OMPLIANCE OFFICE ACCEPTANCE NO `i� if (S' t %3 PROFESSIONAL ENGINEE FI. L. e No: PE 0010983 JAN 2 6 i995 Orate C 0 r 0. L U a S B 5 DIRECT MOUNT ADDITION 9 0 a G W < d N. drnwing no- 94-98.1 ..hrv2 P j, ANCHOR SCHEDULE FASTENER SPACING REQUIRED CINCHES O.C.) EXISTING STRUCTURE HOLLOW BLOCK ANC}(R DCSCRUPTION I/4.0 RAVI CALX -IN V/ 7/8' MIN. EMBEDMENT 1/4'• LTV TAPCON ANCHOR .W/ 1 -1/4' MIN. EMBEDMENT 1/4•0 U.S. SLEEVE ANCHOR V/ I' MIN. EMBEDMENT EIGE DIST. SPAN tL) IN. FT. 2' ' r 1 I 2' 3' r r L S I. r >, 1 IC �. 6' r T' lr Y 1I• �' ID' ANCHOR runs. L FIL OR STUCCO. 2. . FRAMING. FASTENER VOEIL STUD. 3. • Arc -zis SHALL BE AND EDGE DISTANCE EXCLUDES WALL FASTEN TO NARROW FACE OF STUD SHALL BE LOCATED IN CENTER OF A. INSTALLED IN ACCORDANCE "ITN ING WITH THE SOUTH FLORIDA BUILDING CODE DA Br PRODUCI CONTROL DIYIS1ON. BUILDING CODE ,OMPLIANCE OFFICE ACCEPTANCE NO `i� if (S' t %3 PROFESSIONAL ENGINEE FI. L. e No: PE 0010983 JAN 2 6 i995 Orate C 0 r 0. L U a S B 5 DIRECT MOUNT ADDITION 9 0 a G W < d N. drnwing no- 94-98.1 ..hrv2 P • OPTIONAL PRODUCT MAAxD G IOC au XCATICM lUAbaNG LOCATS7o g 116' eS Lana 1423' • Q STORM PANEL SCALE I 1/4' - 0'- 1' ©WINGNUT SCALE 1 HALF SIZE VIDTN UNLIMITED CPERP. TO PANEL SPAN) SECTION ©'h' HEADER SCALE 1114' -a -1' t = MIN. .085' ©KEY HOLE WASHER • SCALE 1 HALF SIZE ITOP MOUNT. OVERLAP FASTENERS CSEE NOTE $ 6) PLAN VIEW TYPICAL ELEVATION BOTTOM MOUNT. - N.T.S. EXISTING STRUCTURE PLAN VIEW SCALE. 1 -12' • 1'-0' CU V 1. 2.939' 452' 1 1 Q 'U' HEADER SCALE 1 1/4' - 0' -1' mural 8 ®'CAB' ANGLE SCALE 1 1/4' = 0' -1' 1. THIS SHUTTER SYSTEM IS DESIGNED iN ACCORDANCE VITH THE SOUTH FL711DA BUILDING CODE, 1994 EDITION. AND HE 1994 SWARD COUNTY EDITION. 2. POSITIVE AND NEGATIVE DESIGN PRESSURE CALCULATIONS SHALL BE PERFORMED IN ACCORDANCE WITH ASCE 7-88 'MINIMUM DESIGN LOADS FOR BUILDINGS AND OTHER STRUCTIRES'. 3. STORM PANELS SMALL BE 20 GAUGE STEEL. Ct = .035'). CONFORMING TO ASTM A446, STRUCTURAL QUALITY, GRADE C. WITH'A MIN. Fy = 40 KSI BEFORE ROLLING, GALVANIZED IN ACCORDANCE WITH ASTM G90. ALUMINUM EXTRUSIONS SHALL BE 6063 -T6 ALUMINUM ALLOY. U.D.N. 4'. PRODUCT MARKINGS SHALL BE WITHIN 12' OF ORE END OF THE PANEL WITH A MIN. OF ONE MARKING PER PANEL AND SHALL BE LABELED AS FOLLOWS. BHPCO FT. LAUD.. FL. DADE COUNTY PROD. APPRD. 5, ALL BOLTS AND WASHERS SHALL BE STAINLESS STEEL. WITH A MINIMUM Fy = 33KSI 6. ALL PANELS SHALL BE FASTENED AT OVERLAPS AT 1/3 POINTS CSEE TYPICAL ELEVATION), HOWEVER, PANEL SPANS. SMALLER THAN 48' MAY BE FASTENED AT MIDSPAN. FASTENERS SHALL BE 1/4 -20 x I.''SIDEVALK BOLTS W/ DIE CAST ALUMINUM VASHERED VINGNUTS. 7. MATERIAL SPECIFICATIONS NOTED HEREIN ARE THE MANUFACTURER'S REPRESENTATION OF MATERIALS TO BE USED IN PRODUCT TESTING. 8. IX DETAIL` AND SPECIFICATIONNS SHIYN XEREIN REPRCCFEUT THE PRODUCTS PROPOSED FOR IMPACT. CYCLIC AND UNIFORM STATIC AIR PRESSURE TESTING IN CONFORMANCE WITH DADE COUNTY PROTOCOLS PA 201, 203, AND 202 VITH DESIGN LOADS AS FOLLOWS, POSITIVE DESIGN LOAD + 61.5 PSF NEGATIVE.DESIGN. LOAD — 61.5 PSF DESIGN BASED ON CRL REPORT $ S1013. S1013A G S10138. 9. A YARNING NOTE SHALL BE PERMANENTLY- PLACED ON EACH PANEL OR SILL OF PANELS ADVISING THE NOME OWNER OR TENANT THAT. THE STORM PANELS WILL NOT OFFER HURRICANE PROTECTION UNLESS ALL REINFORCING $OLTS ARE PROPERLY INSTALLED. 10. TOP 1. BOTTOM DETAILS SHAN MAY BE .INTERCHANGED AS FIELD CONDITIONS DICTATE. PANELS MAY BE )CUNTED H4RIZD4TALLY VIERE APPLICABLE. • • r OVERLAP AL ANGLE E. 1' x 2' x .125' MIN. TO 2' x 3' x .I25' MAX. SHEAR FASTENER 2 24' GC. - EXISTING PIMUCT RENEWED ACCEPTANCE No..T_ 67 I Z • 06, 1 +90 125' TYP. 5.0V (� ANGLE APPROVED AS COMPLYING VWITH• THE SOUTH FLORIDA BUILDING CODE DATE BT - PRODUCT CONTROL DIVISION BUILDING—CODE COMPLIANCE OFFICE ICCEPTANCE NO qy — 115- C3 ("' OFESSICINAL ENGINEER ° ; • •?�. .A d LM a .. I.. OVERLAP FASTENERS CSEE NOTE $ 6) PLAN VIEW TYPICAL ELEVATION BOTTOM MOUNT. - N.T.S. EXISTING STRUCTURE PLAN VIEW SCALE. 1 -12' • 1'-0' CU V 1. 2.939' 452' 1 1 Q 'U' HEADER SCALE 1 1/4' - 0' -1' mural 8 ®'CAB' ANGLE SCALE 1 1/4' = 0' -1' 1. THIS SHUTTER SYSTEM IS DESIGNED iN ACCORDANCE VITH THE SOUTH FL711DA BUILDING CODE, 1994 EDITION. AND HE 1994 SWARD COUNTY EDITION. 2. POSITIVE AND NEGATIVE DESIGN PRESSURE CALCULATIONS SHALL BE PERFORMED IN ACCORDANCE WITH ASCE 7-88 'MINIMUM DESIGN LOADS FOR BUILDINGS AND OTHER STRUCTIRES'. 3. STORM PANELS SMALL BE 20 GAUGE STEEL. Ct = .035'). CONFORMING TO ASTM A446, STRUCTURAL QUALITY, GRADE C. WITH'A MIN. Fy = 40 KSI BEFORE ROLLING, GALVANIZED IN ACCORDANCE WITH ASTM G90. ALUMINUM EXTRUSIONS SHALL BE 6063 -T6 ALUMINUM ALLOY. U.D.N. 4'. PRODUCT MARKINGS SHALL BE WITHIN 12' OF ORE END OF THE PANEL WITH A MIN. OF ONE MARKING PER PANEL AND SHALL BE LABELED AS FOLLOWS. BHPCO FT. LAUD.. FL. DADE COUNTY PROD. APPRD. 5, ALL BOLTS AND WASHERS SHALL BE STAINLESS STEEL. WITH A MINIMUM Fy = 33KSI 6. ALL PANELS SHALL BE FASTENED AT OVERLAPS AT 1/3 POINTS CSEE TYPICAL ELEVATION), HOWEVER, PANEL SPANS. SMALLER THAN 48' MAY BE FASTENED AT MIDSPAN. FASTENERS SHALL BE 1/4 -20 x I.''SIDEVALK BOLTS W/ DIE CAST ALUMINUM VASHERED VINGNUTS. 7. MATERIAL SPECIFICATIONS NOTED HEREIN ARE THE MANUFACTURER'S REPRESENTATION OF MATERIALS TO BE USED IN PRODUCT TESTING. 8. IX DETAIL` AND SPECIFICATIONNS SHIYN XEREIN REPRCCFEUT THE PRODUCTS PROPOSED FOR IMPACT. CYCLIC AND UNIFORM STATIC AIR PRESSURE TESTING IN CONFORMANCE WITH DADE COUNTY PROTOCOLS PA 201, 203, AND 202 VITH DESIGN LOADS AS FOLLOWS, POSITIVE DESIGN LOAD + 61.5 PSF NEGATIVE.DESIGN. LOAD — 61.5 PSF DESIGN BASED ON CRL REPORT $ S1013. S1013A G S10138. 9. A YARNING NOTE SHALL BE PERMANENTLY- PLACED ON EACH PANEL OR SILL OF PANELS ADVISING THE NOME OWNER OR TENANT THAT. THE STORM PANELS WILL NOT OFFER HURRICANE PROTECTION UNLESS ALL REINFORCING $OLTS ARE PROPERLY INSTALLED. 10. TOP 1. BOTTOM DETAILS SHAN MAY BE .INTERCHANGED AS FIELD CONDITIONS DICTATE. PANELS MAY BE )CUNTED H4RIZD4TALLY VIERE APPLICABLE. • • r OVERLAP AL ANGLE E. 1' x 2' x .125' MIN. TO 2' x 3' x .I25' MAX. SHEAR FASTENER 2 24' GC. - EXISTING PIMUCT RENEWED ACCEPTANCE No..T_ 67 I Z • 06, 1 +90 125' TYP. 5.0V (� ANGLE APPROVED AS COMPLYING VWITH• THE SOUTH FLORIDA BUILDING CODE DATE BT - PRODUCT CONTROL DIVISION BUILDING—CODE COMPLIANCE OFFICE ICCEPTANCE NO qy — 115- C3 ("' OFESSICINAL ENGINEER - Page 4 PERMIT APPLICATION OFFICE USE ONLY CHECRLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) •❑ OTHER (Specify & Attach) ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT APPLICATION Master Permit No. Subsidiary Permit No. r .0Thoo INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Submit the completed applications 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.. - Step 2. PERMIT FEES $3.00 per page (Scanning Fee) Miami Shoe Village Bond Metropolitan Dada County (C C F ) Inspector State Educational Fund State DCA (Radon) Code Enforcement-Fine=- -- Zoning Review ISSUING OFFICIAL (sq.ft. = x/1000_ x ¢.60) ;$ (0.005tsq.ft) _s 0 0 (0.01tsq.ft.) TOTAL REVIEWED AND PREPARED BY: DATE: SECTION Name BY �� DATE Aire 57.13( Zoning a, Repair Fax Electrical Demolish Mechanical Shell ;Only- _— _ Foundation Only _ Plumbing Add'l Attachment Other Fire Other Public Works Structural Building Officiale_,��, Z� CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL *(305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com APPLICATION Job Address: 4 o l. N C I 03 Address T Apt. M . S%1r0R S FL 33►3 City- State Zip Folio Number Description of Work PA i741-+ AT a XTS 7 .lO iZ. t f A6-U'3 Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information Zoning Linear Feet Square Feet Value of Work Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Units Floors 00 06 Bldg Value PERMIT TYPE (✓ ) Building- - Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) C'hg.- Contractor Renewal Revision –Extension Supplement Reinspection ARCHITECT Name License No Address Telephone Fax PROPERTY OWNER New Construction Name Li 1412.0 Lt VOW A "%M i/G R ©SSM Address ifo1 tos 1c3 Sr Hone Telephone (os) -(sg' -- 140 Business telephone SA M a. Repair Fax Alteration Interior TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Telephone Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell ;Only- _— _ Foundation Only _ Add'l Attachment Other Add'I Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No Address Telephone Fax Qualifier Name Page 2 PERMIT APPLICATION Page 3 PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBTIW 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 links. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. 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 FT T CTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other iSermit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Si o:tfivner X' S`'i'!I: P1-4A NI i e L,I N Print Name and subscribed before me thus b) day of Si of `s Public - State •f Fl. da . SEAL: Personally known C PSIY PVe' ANGELA M pECKER ooloAssoN NANO ily Type of Identification Produced: tis yip �3o 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 OR, Produced Identification Type of Identification Produced: INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE Minimum Fee QTY. TYPI; Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Mr Handler, Tons A/C Central 4-7 Ton - Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECI-IANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPI; Generator QTY. TYPE Refrigeration, Tons QTI'. A/C Central, Tons Cooling Tower - Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of ® Paint Booth Ventilation, Cost Solar Water Heater Mr Handler, Tons Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections iodic IFi Barbecue Fire Sprinkler _ - I . r . y r '4 1 Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUMBING TYPE A/C Condensate QIY. "TYPE, Drains, Roof QIY. TYPE Miscellaneous Fixture Q'II'. TYPI: Soakage Pit QTY. 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: ROOF COVERING MATERIALS (TEVT) ROOFING SYSTEMS (TGFU) — Continued 2. Ashland Chemical Inc. bonding system. The membrane is adhered with "PLIOBOND 2375" bonding adhesive, applied at 60 sq ft/gal. The membrane laps are sealed with "PLIOBOND 9053' lap adhesive at 131 lin ft/gal. The lap edges are caulked with "PUOBOND 5533'. 78. Deck: NC Incline: 1/4 Insulation: Polystyrene or polyisocyanurate, any thickness. Barrier Board: Wood fiberboard, 1 in. min, or one of the following boards at 1/2 in. min: Celotex Corp. wood fiberboard, Georgia -Pacific "Sturdi -Top" or Huebert Fiberboard fiberboard. Membrane: "EPOM ", 45 to 60 mil, fully adhered with Uniroyal Inc :s 'Royal M6504" adhesive at 75 sq ft/gal. The membrane laps are sealed with Uniroyal Inc :s "Royal M6365" adhesive at 1/2 gal/100 sq ft and the lap edges are caulked with Uniroyal Inc :s "Royal M6389". 79. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Perlite or glass fiber, 15/16 in. thick min, or polyisocyanurate, 2 in. thick min, joints in insulation offset 6 in. with points in deck. Base Sheets Two or more plies "MB Base Sheet (Type G2) or any Type G2 weighing a min of 23 lbs /sq, mechanically fastened, spot or fully mopped. Ply Sheet (Optional): "APP 160" or "APP 170" (modified bitumen), heat fused. Membrane: "APP 180 FR" (modified bitumen), heat fused. . 80. Deck NC Incline: 1 Insulation: Polystyrene (I to 2.5 lbs /cu /ft), 1 in. min. Slip Sheet: 20 mil " Manniglas 1200". Membrane: " UltraPly 78+" (TPA), 40 -100 mil 81. Deck NC Incline: 1 Insulation: 'ISO 95 +GL" or perlite, any thickness. Membrane: "UltraPly 78+" (TPA), 40 -100 mil. 82. Deck: NC • Incline : 1 -1/2 Insulation (Optional): Polystyrene. (tapered or uniform thickness) or Dow Chemical 'Styrofoam LG, PD, RM, SM, TG or STYROIB" or "Irmagard ", any thickness or glass fiber, any thickness. Insulation: Wood fiber (Huebert) 1 in. or "Firestone Fibertop E °, "Fibertop C", "Fiberstop S" or "Fiberstop SE", 1/2 in. min. Membrane: " UltraPly 78+" (TPA), 40 -100 mil 83. Deck: NC Inclines 1 Insulating Concrete: Deck covered with either of the following insulating concretes (poured in place): cellular, vermiculite, perlite, gypsum or structural. Optionally, a base concrete deck may be used if all exposed surface joints are grouted. Membrane: "UltraPly 78+" (TPA), 40 -100 mil 84. Deck C -15/32 Incline: 1 -1/2 Insulation (Optional): Any UL Classified, any thickness. Barrier Board: Gypsum wallboard, 1/2 in. nom, joints in wallboard offset 6 in. with joints in deck. Membrane: "UltraPly 78+" (TPA), 40-100 mil. 85. Deck: NC Indies: 3 -1/2 Insulation (Optional): Any UL Classified, any thickness. arrier Board: Regular or water resistant wallboard, 1/2 in. nom. Me 86. Deck: C -15/32 Incline: 1/2 Insulation (Optional): Perlite or lass fiber, 15/16 in. thick min, or polyisocyanurate, 2 in. thick min, joints in insulation offset 6 in. with points in deck. Base Sheet: Two or more plies "MB Base Sheet" (Type G2) or any Type G2 weighing a min of 23 lbs /sq, mechanically fastened, spot or fully mopped. Ply Sheet (Optional): "APP 160" or "APP 170" (modified bitumen), heat fused. Membrane: "APP 180 FR" (modified bitumen), heat fu 87. Indi Insula _ " erm AP", "Hy -Tec", "Hy-Tec Plus', 'Energy Lok" or "Hy-Tec Plus II°, A s "AC Foam I° or "AC Foam II ", NRG Barriers "E'NRG'Y 2", Rmax °Multi-Max FA ", Schuller International "UltraGard ", Apache °White Line" or Pyrox, any thickness. Membrane: "LS -FR" (EPDM), 45 or 60 mil. 88. peck NC Incline: 3/4 Insulation (Optional): Any UL Classified, any thickness. Insulation: Wood fiberboard, 1/2 in. thick mm. • Membrane: "LS -FR" (EPDM), 45 or 60 miL 3 2 89. Deck: NC Insulation (Optional): "ISO 95+ GL ", wood fiberboard or partite, any ickness. '%5411" (Ink% 48 or 80 f� u� nsu on: Georgia - Pacific "Dens -Oec 1/4 in. thick min. Membrane: " UltraPly 78+" (TPA), 40 -100 mil - - Class B - Fully Adhered 1.. Deck: NC Incline: 3 Insulation: Wood fiber (Huebert), 1 in. to 2 in. thick, or "Firestone ROOF COVERING MATERIALS (TEVT) 119 ROOFING pSYSTEMS (TGFU)— Continued Fibertop After the ePDN is allowed to weatheorrfor approximately two Membrane: "Standard. weeks, °PC -100 Coating" at 1 gal/sq. Optional: General purpose or silica sand (sieve size of 50 to 100) may be applied into the wet coating at 35 lb/sq. Incline: 1/4 2. Deck: C-15/32 Slip Sheet: "Manniglas 11510X", foil side down, mechanically fastened.. Membranes °Standard RubberGard" (EPDMM), 5i or 60 mil 3. Deck: C -15/32 Base Sheets OCF "No. No. 28 Permapl", hot mopped or nailed. Membrane: 'Firestone APP 160", Firestone APP 170" or "Monoply Plus', heat fused. Coating: Western Colloid "No. 298 Emulsion ", applied at 1 -1/2 gal/sq, Fields Products "No. F900" applied at 6 gal/sq, Gilsonite "Durakote No. 151 ", applied at 6 gal/sq or Gibson- Homans "No. 6192 -900", applied at 5 to 7 gal/sq. ' Surfacing: No. 11 roofing granules applied at 50 lb /sq. 4. Deck: C -15/32 Incline: 1/4 Insulation Optional): Perlite, glass fiber, isocyanurate, "Rhoflex Isocyanurate , urethane or composite, any thickness. Base. Sheet or Insulation: Two layers of Type G2 OCF or Schuller International "No. 28°, or any UL Classified insulation (except EPS), 1 in. min, optionally covered with 1/2 in. min wood fiberboard, 1/2 in. min gypsum wallboard, 1/2 in. min perlite or 11/16 in. min glass fiber may be substituted for one layer of "No. 28" Base Sheet. Membrane: "Firestone APP 160", *Firestone APP 170" or "Monoply Plus" (modified bitumen), heat fused. Surfacing: Karnak Chemical °No. 97 Fibered Coating" applied at 1 gal/sq or "No. 97 AP', applied at 1 -1/2 gal/s�ciine :l/4 5. Decks 15/32 ne, min 1 in. Insulation: One or more layers of UL Classified polystyrene, Insulation: One layer of min 1/2 in. wood fiberboard. Base Sheet: One or more layers of OCF No. 28 base sheet, hot mopped or cold application adhesive. Membranes "Firestone APP 160", "Firestone APP 170" or"Monoply Plus" (modified bitumen), heat fused. Coating: Karnak No. 97, applied at 1 gal/sq or "No. 97 AF°, applied at 1 -1/2 ga sq. 6. Deck: C -15 /32 Incline: 2 Insulation (Optional): Perlite, fiber glass, wood fiber, isocyanurate, "Rhoflex Isocyanurate , phenolic, foam glass, urethane or composite, any thickness. • Base Sheets OCF No. 28, Schuller International "Glasbase" Bird CRS base or GAF -Glas, hot mopped, cold application adhesive or mechanically fastened. Membrane: "Firestone APP 160", °firestone APP 170" of ' Monoply Plus" (modified bitumen), heat fused. Cap Sheet: Bird Inc. "CRS Cap Sheet", OCF "Cap Sheet", GAF "GAFGLAS Mineral Surfaced Cap Sheet" or Schuller International mopped or adhered with Karnak Chemical Corp. cold application adhesive No. 81. 7. Deck: C -15/32 Inclines 1/2 Base Sheet: Two layers OCF °No. 28", Schuller International "Glasbase" or GAF "GAF -Was" (Type G -2), hot mopped, cold application adhesive or mechanically fastened. Membrane: "Firestone APP 160", "Firestone APP 170" or " Monoply Plus' (modified bitumen), heat fused. Surfacing: Karnak Chemical "No. 97 ", applied at 1 gal/sq. 8. Deleted Incline: 3 -1/2 9. Deck C -15/32 Barrier Board: Water resistant wallboard, 1/2 in. nom, joints in wallboard offset 6 in. with joints in deck. Insulation: Wood fiber (Huebert), 1 in. to 2 in. thick or Firestone "Fibertop E ", " Fibertop C", ° Fibertop 5" or "Fibertop SE", 1/2 in. to 2 in. Membrane: "Standard RubberGard° (EPDM), 45 or 60 mil. Surfacing: After the EPDM is allowed to weather for approximately two weeks, "PC -100 Coating" at 1 gaVsq. Optional: General purpose or silica sand sieve size of 50 to 100 ) may be applied into the wet coating at 35 lb /sq. Incline: 1/4 10. Deck: C -15/32 Insulation: Any UL Classified polyisocyanurate or phenolic, I in. thick min. Base Sheet: Two layers Type G2 or one layer UL Classified 'Type VI' ply sheet, mechanically fastened or hot mopped. leembraner Moutons APP 180'. 'Master a APP 170" as Vanaply Plus' (modified bitUmenbmen), heat fused. Surfacing: Karnak Chemical Corp. °Kaak No. 97 ", 1 -1/2 gal/sq. 11. Decks C -15/32 Incline: 1/2 Insulation (Optional): Any UL Classified, lyisocyanurate, perlite/ polyisocyanurate composite, phenolic, perlite /phenolic composite, glass LOOK FOR MARK ON PRODUCT Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/23/2005 Plumbing Permit Permit Number: PL2005 -141 Page 1 of 1 Applicant: Owner: JOB ADDRESS: 401 NE 103 ST Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 -7859 Parcel # 1122310150130 Contractor's Address: P 0 BOX 693239 Legal Description: MIRROR LAKE SUB PB 56 -15 LOT 13 LESS N34.25FT & ALL LOT 14 LOT SIZE Fees: Description Amount FEE2005 -5482 Building Fee $175.00 FEE2005 -5483 Training and Education Fee $0.60 FEE2005 -5484 Technology Fee $4.37 FEE2005 -5485 Scanning Fee $3.00 FEE2005 -5486 Builders Bond $300.00 FEE2005 -6451 CCF $1.80 FEE2005 -6452 Notary Fee $5.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $489.77 Permit Status: APPLIED Permit Expiration: 11/1/2005 Construction Value: $2,500.00 Work: REPLACE DRIANFIELD AND TANK 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 accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/23/2005 Plumbing Permit Permit Number: PL2005 -141 Page 1 of 1 Applicant: Owner: JOB ADDRESS: 401 NE 103 ST Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 -7859 Parcel # 1122310150130 Contractor's Address: P 0 BOX 693239 Legal Description: MIRROR LAKE SUB PB 56 -15 LOT 13 LESS N34.25FT & ALL LOT 14 LOT SIZE Fees: Description Amount FEE2005 -5482 Building Fee $175.00 FEE2005 -5483 Training and Education Fee $0.60 FEE2005 -5484 Technology Fee $4.37 FEE2005 -5485 Scanning Fee $3.00 FEE2005 -5486 Builders Bond $300.00 FEE2005 -6451 CCF $1.80 FEE2005 -6452 Notary Fee $5.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $489.77 Permit Status: APPLIED Permit Expiration: 11/1/2005 Construction Value: $2,500.00 Work: REPLACE DRIANFIELD AND TANK 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 accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPT.ICATION Fsc 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795 :4305) 756.8972 oec d r.', Permit Type (circle): Owner's Name (Fee Simple Owner's Address City Tenant/Lessee Name ermit No. pI05 141 !Waste Permit No. Electrical ° umbing 1Vt chanical Titleholder) o hone # �i-e�,h�nl� L!, r�5 !� S Roofing State Zip Phone # Job Address (where the work is being done) 40( -.NE' _105 54- City Miami Shore's "Vill. a County Miami -Dade Zip Is Building Historically Designated YES NO X Contractor's Company Nane V i l.. , Phone Contractor's Address .. I (4 Nu.) Z f L€ City M ( op--t 1 State F Qualifier Zip State Certificate or Registration No. Certificate of Competency No. Architect /Engineer's Name if applicable) Phone # $ Value of Work For this Permit 2500 Square Footage Of Work: ['Addition ['Alteration [New DIc i Type of Work: Describe Work: D Repar/>1eplace', El Demolition **4********** ************Fees****************************** Permit Fee $ 1-1 5 .Q Q I CCF $ I f 0 ✓ CO /CC Training/Education Fed $ . GO Technology Fee $ -II i Radon $ Zoning Structural Plan Review. $ Submittal Fee $ Notary $ 5.0 Scanning $ '5 00 Code Enforcement $ Total Fee Now Due $ (Continued on opposite sid \\Q\ Bond $ 0 op .51.k Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 WTTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this day of ,.20 _, by who is personally known to me or who has produced. As identification and who did take an oath. , NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature Contractor The foregoing instrument was acknowledged before me this day of ,20 ,by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: erl AR Plans Examiner Engineer Zoning Chc 05/13/03 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT [ ]New System [ [ X ]Repair APPLICANT: Lincoln, FOR: ]Existing System [ ]Holding Tank ]Abandonment [ ]Temporary [ NA Stephanie CENTRAX #: 13 -SG -24849 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 05- 1436 - -R [ ] Innovative Other AGENT: SR0931119, COCKING MSTEPHEN PROPERTY STREET ADDRESS: 401 NE 103 St MI LOT: 14 BLOCK: N/A Shores FL 33138 SUBDIVISION: Mirror Lake Sub [Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] PROPERTY ID #: 11 -2231- 015 -0130 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ] N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 150 ]GALLONS DOSING TANK CAPACITY [ 33 ]GALLONS @ [6 ]DOSES PER 24 HRS # PUMPS[ 1 ] MULTI - CHAMBERED /IN SERIES: [Y ] D [ 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED [ N ]MOUND [ N ] I CONFIGURATION: [ N ]TRENCH [ N ]BED [ N N F LOCATION TO BENCHMARK: F F E, /R 12.00'ngvd I ELEVATION OF PROPOSED SYSTEM SITE [ 3.8 ] [ FEET E BOTTOM OF DRAINFIELD TO BE [ 5.5 ] [ FEET L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 21.0 ] INCHES ] [ BELOW] BENCHMARK /REFERENCE POINT ] [ ]BENCHMARK /REFERENCE POINT OTHER REMARKS: [CP] Rear system repair only.Install 900 & 150 gal. category -3 septic & lif- dosing tanks equipped with an approved filter & one approved pump. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with sec. 64E- 6.013(3)(f), FAC. Install no less than 200 sq. ft. Invert elevation of drainfield to be no less than 6.95' NGVD. 'Bottom of drainfield elevation to be no less than 6.45' NGVD. SPECIFICATIONS BY: RAM, Arrieta, Roland TITLE: APPROVED BY: Arrieta, Rolando TITLE: Engineer I Dade CHD DATE ISSUED: 5/4/05 EXPIRATION DATE: 8/2/05 DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ostds_cons_4016 -1] Page 1 of 2 PPLICANT: LOT: PROPERTY ID #: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS .044vvie BLOCK SUBDIVISION: AGENT: . a( ��( z rteile. h 16 T(.,A • [Section /Township /Range /Parcel No. .or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] TOTAL ESTIMATED SEWAGE FLOW': 3 at) AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE• YES [ ] NO NET USABLE AREA AVAILABLE: • ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: ( -B SQFT BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS (. [INCHES /FT] [ABOVE /BELOW] BENCHMA'itR /REFERECE POINT !s.# rh5v,c, THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: FT DITCHES /SWALES: / FT NORMALLY WET? [ ] YES [ ad FT LIMITED USE:,/ FT PRIVATE"( FT NON- POTABLE: /418 FT WELLS: PUBLIC: 5* FT PROPER LINES: '941 FT` POTABLE WATER LINES: 2_5 FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES NO 10 YEAR FLOODING? [ ] YES [ /'NO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: /O./ FT MSL /NGVD SOIL PROFILE INFORMATION SITE 1 41 4-j°(: C/' SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture Depth r 1 to AMMONNEW ?ATULAAMMip, 2, tor/ to to to to to USDA SOIL SERIES : 4 A„/e✓ to Munsell // olor Texture Depth to to to to to to to to to USDA SOIL SERIES://4U14 10414 OBSERVED WATER TABLE: ',IA- INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ ABOVE BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES (/(NO MOTTLING: [ ] YES 01 NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: /Y I, DEPTH OF EXCAVATION: :7't INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH ( —] BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: SITE. EVALUATED BY: DATE DH 4015, 10/96 (Replaces FIRS -H Form 4015 (Page 3) which may be used) (Stock Number: 5744 - 003 - 4015 -1) Page 3 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PER Permit ApplicatioriNimber PART II - SITE PLAN- Scale: Each block represents 5 feet and 1 inch = 50 feet. 7-7 r 4.4., 24D a t-••••79 - 4. • • , , • • • . = -7— . . . - • T. , • - ' . Notes: Site Plan submitted-,_ Plan Approved Stgiiiiture Not Approved By • Title Date County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015. 10/98 (Replaoss HRS-H Form 4015 which may be used) Moak Number: 5744-002-4015-6) Page 2 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMiT.;.:, Permit Application Number • PART II - SITE PLAN- Scale: Each block represents 5 feet and 1 inch = 50 feet. • PI' opyi44, _ 1,iti- -• 4. . . „ •• ,,,,,,,,rt....- -- , , , ''''''''''''''"*......=-,...,..t.taaa..-a• a t . . ......,.....— -.......................—,-- t .... .. . ,..,..14, , ,--,,i• • ---- - - .- }, -- -- - -° - -...-----“— ; " rl. TO." 1. .."' Cr 1 "i` , 'l' L— _ , t„ : -7" ' 1.--- T • ' 4^-^"...".,, .... a. -............. . . • • i" ; .• 7 . `••• • ,.„,,,;4.•""*" •17.• •• --a•-•-••• 4 i 4 , ; , ' . 4,. ^ 4,-;- • r • . • : " • 4 . t • • ' t• • , • ' • / • _14 • • • . -` ^ ' 7 •g. • • • p : - . ' • e•-s: ,,■■ L-44-444-„i44,44,44,....•,„4.4.4,4,..4.44-444,;444 • Notes: 4. Site Plan submitted by: Plan Approved By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Signature Not Approved ' ,„• • .„ , Title Date DH 4015. 10/99 (Replaces HRS-H Form 4015 vetch may be used) (Stock Hunter:5744-002-4016A Page 2 of 3 ELEVATION CERTIFICATE Owners Name: HERMINIO E. FERNANDEZ & S L LINCOLN & G K GROSSMAN Property Address: 401 NE 103RD STREET, MIAMI SHORES, FL. 33138 LEGAL DESCRIPTION: FOLIO #: 11- 2231 -01' 5 -0130 Lot 13 LESS N34.25FT & ALL LOT 14, Block N/A of "MIRROR LAKE SUB" according to the plat thereof as recorded in Plat Book 56 at Page 15 of the Public Records of Dade County, Florida. SURVEYOR'S NOTES: 1) Not valid without the signature and the original raised seal of a Florida Licensed Surveyor and Mapper. 2) Additions or deletions to this certificate by other than the signing party or parties are prohibited withoct written consent of the signing party or parties. 3) This certificate elevation is for the purpose of septic and drains repair and/or construction. 4) This certificate elevation must not be use for the purpose of acquiring flood insurance 5) Elevations are based on the National Geodetic Vertical Datum of 1929. 6) Flood Zone: N/A Base Flood Elev.: N/A as per Dade County, Florida. FEMA Panel Number: 120652 - 0093 - J - MARCH 2, 1994 TOP OF BOTTOM FLOOR: TOP OF NEXT HIGHER FLOOR: ATTACHED GARAGE (at the door): GRADE © DRAINFIELD AREA CROWN OF THE ROAD: Field Date: 4/19/05 12.0' N/A 10.2' 10.4' 10.1' Pablo J. Alfonso P.S.M. Professional Surveyor & Mapper State of Florida Reg..No.6880 I LAND BURN/EYORB. INC. o1i5 NW 153r6 STREET, SUITE 103, MIAMI' LAKES, !FLORIDA 33014 Phone: 305- 822•6062 +' 305- 898•9468 '• Fax! 305. 827.9669 07/14/2005 11:07 3056515610 S. MR C SEPTIC DRAIN CO PAGE 03 11% t.4 QC-MINTZ • ITN smar- DIPOS4-' CONSTRUCTION INVIDECTI 'AND Y • 40•11071" max r 1 031 ourr reu Raj r,u,rtikj f fosi OUT fra. I 12 - / rinniutia0191=9 [ I KV t I psi- • .°■01010r130] • • I I 1313 [06] LE ax= [ 32j [ I [ 08 j 3,2FEL 7'0 r [ 1 [34] PROPINTIEt FT E [0 IM7] TMS= 1331 Dr= mail- .pudia lams zautaaraaar unaelit L [ ] 109e1)11)211 TO LID DRAINFIRLD INSENUAzzoN 1 1 1101 Alga 11112X./ Y 121 Ban gjowlittigisiMiMON noz READER ..1Z 1 I 1121 sonoloa or Doolmilloo I t j (13] DRAINLXEN SEPARATION 4 ...I [ (14) aukumnUe :czars t 1 [15] Diritii OF co VOL 1 1 (16) ILEVATION tationisamawl au 419 tin amnia tocaTrima • ,1" I titjutlantia mint ••••••••..e.11N•IPM.MM La) AGGREal= I 3 [201 . A0011ROJLTS RiolierFa rizzfearr 1 3 [21 MAMA= Danz • ] 5) MIIIM FT FILL / Exestirivar, 1221 FILL 'MUM _2 cf, - [23] FILL Timms 124j EXCAVATION MTN, [25] ARRA IRMA= [26] ENFLACENINT 301TARiAL 111111110 ) (36] DEAMOVERCD*40091A '4'441*.41" j [37) AROOLMOME I (3$] grapss ) [39] smaimamulam ADDITIONAL 1 1401 ) 141) " lamina* mALAnMoO rOk IR IS ( 3 [421 —'WOW amormun At] 11 44 aunanak, *aka ‘11 1451 Wean= mom= •st22 imam j 614) r Amos 9001* [dal •OMER --4816-+101417,,s i;;46-7sool' • ) ' ''a■•• IztPLARATION 0, VIOLILTIceiti / unuatust " • AfiiiiMPOWIT S I ram mow raw= 1-adtw mom CRUSSID a rnzau—__11 11•••••MIMMINYMNIMIMmla..7. •■■••Pl• DISAPPEOVED] OR 4016, 1 r.vLov ';'idlitions Noy Ea • T • • PT 1: afplkAild • .4 ▪ DATA: CID AiTZ 7- 6, L. •. ries 3.44 3 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/23/2002 Building Permit Permit Number: BP2002 -985 Applicant: LINCOLN /FERNANDEZ/ GROSSMAN Owner: JOB ADDRESS: 401 NE 103 ST Contractor Local Phone: Parcel # 1122310150130 Contractor's Address: Page 1 of 1 a e, Legal Description: MIRROR LAKE SUB PB 56-15 LOT 13 LESS N34.25FT & ALL LOT 14 LOT SIZE& Fees: Description Amount FEE2002 -2977 CCF $0.60 FEE2002 -2978 Building Permit Application Fee $60.00 FEE2002 -2979 Notary Fee $5.00 Total Fees: $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 11/19/2002 Construction Value: $900.00 Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT) If there is no permit package accessible on the job site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 111&6$9411.g$ Vu* 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: PECTOR) 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: Os ..C17% • t • 1.491. Miami Shores, FL 33138-2456 Date 6n3:1421u 63892321 STEPHANIE LINCOLN order of (6• GPO 401 NE 103rd St Pay to the M1 t CtovJ tCrt10 Dollars 8 Peewee Beek SouthTrawust taak.FulD 1:063 /0914301: /9 016 1030 For Money Multiplier Checking HitPtiaD 2000 L c9, .F •.•'" • t • Yr MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 5.20 b2._ OWNER'S NAME: LI N cam- =E JJAN DE2/ PHONE: (30s) 7 714o ADDRESS: 4D1 ry Io3ci S- c42...osswIA -f.f ************************ 1********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: 4o t NE 1 o3 r4 Sr CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 11 Elements on the site must be listed and indicate the color two be a�n' \ted. Walls Loi,, .e„ Fascia Jo 04,1�H-p.0 Drip Cap/Drip Edge Soffit We" E4T (.443 USE PO1 u-r- Roof �32t s� 'p - a'' o'1 3�*tal ,A„e�r Lake Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors .i R1 s Cites E. Railings 13R1 s tC £ LU E Fences Decorative Metal 3R iS (w E All brick (simulated or regular) Stucco Banding Any other stucco features Accessory'Buildings Other i31zi i . 1311% Lighthouse Pointe • 45W79/256 79/256 ,��iiN• / 51 m N CO y N U Ga e �s in z cn ka..0 ` *a lie, s iikelt 0-) i OWNER'S AFFIDAVIT: I certify that all the foregoing is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached a les. 2o- ®2 gnature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: )/0 X Building 0 ial Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 The Secretary of State . • • - . •-:-,-•••••:;• •.---:_•-- . of the United States of America •...•,--. .. hereby requests oll whom it may concern -to permit the citizen/ of the United States named herein to •::-....'-iijithout delay or hindrance and in case of neeibfii§ -,:-..•-. -•-‘,-.. give all lawful aid and prOtectton. Le Secretaire d'Etat des Etats-Unis d'Amerique r ou resortissa des Ets-Unis titulaire du prisent'pas i snt taseport,' prie par les prisentes touter autorites competentes de hisser passer :le cito ., .. , Sans alai ni difficulte et, Len cas de besoin, di lui acciii.der • --..- -.H...• toute aide et protection. ligitimes. . ,.. ,-,4'..--•-:,-.. • .',.....,t••,c.:.,-,- :::...:;;;.:-..:... SIGN OF BEA NOT VAUDAINIIL SIGNED , s TYPe/CagoIrtY Code of issuing i Cominamoupayrs PASSPORT NO./NOPASSE Stale sprname Ron , 045189730 Ayala PPletti:'77'..- • ---3-j2: NaolagyF UAW E LEE UNITED STATES OF AMERICA Date at birth 4:Eike* nalssaii#:,---:.= S2 Sex ,..3........ .5., gay Aa* 98 30 ' Modlfieat'ons O:1 SEE PAGE MIAMI A ' PASSPORT AGENCY \ ._.- �p P,..ei.ISALINCOLN<<STEPHANIE<LEE<<<<<<<<w.f<<<<<<<< 4_417' '..--.113971-1i$1.1S A5301089 F0806305 '-:. ,-...=-Pa. -., U TITULAIltE PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ///.t /0/ Job Address T ®/ # e/039 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant — 5;*".% **4' Master Permit # Owner's Address % o/ Phone Arne Contracting Co. Address e3SCIi >����. AI; Q u a l i fi e r �/�G,% -r SS# ` Phone ftV 3P7, State # G. 2/!/ --3 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAI<CLUMBINi)MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION A ®G/� ,rer.9. 1C 4/0 C °�%/''w✓ 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 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 wdrk will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for Fi .F,CTRICAL 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. Furth. u • , I authorize the above -named contractor to do the work stated. Signa e order and/or Condo President Notary as My C , {r'_rr «,orit .ss ; '. tit • *,��£ �! .,iY'5 ' '�L RIDA ion a -+ FfisSION NO. CC723471 MY COMMISSION EXP. MAR. 28,2002 I II II ` FE'S: PERMIT 0 RADON Date APPROVED: Zoning Building Mechanical C.C.F. NOTARY NOi AID'. SEAL BUD TW' OI D NOTARY PIJI UC STATE ATE O FLORIDA COMM CSW)N NO. CC724953 MY COM.,; 1.` ,5'O €:),'P. AIJ° 1,2©02 BOND to TOTAL DUE G V ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM BATH TLE UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN , SIZE IN ANN DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER IiQTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE , OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL ' MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION VIOLATION INDIRECT WASTES A/C WINDOW WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT 1 STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 4-......4 • H EATER-NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION VIOLATION -� PUMP 8 ABANDON SEPTIC TANK SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM 3AS RANGE METER SET (GAS) OAS PIPING BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING PERMIT ROOFING 0 h- IM�O�iv/ Owner of Building Architect Contractor or Builder Legal Description Address of Building 4D/ �(� 7 9) 0 / O 3 59/ N° 48227 Date Contractor's License No Work to be performed under this Permit C� 9� a ®f/1 14/276 L ' (97;45 C9-4(1rac:1-cY-C Lot tt IIB1r! This permit is granted to the contractor or bu' don herefor in strict compliance with all ordinanc plans, drawings, statements or specifications that m at any time if the work is not done in compliance permit is granted is the understanding that the regulations pertaining to the work covere sibility for work done by his agents, In conside pertaining the In acceptin Signed of the iss l,rnor idle sv� Snvisonl /- 2A3/D/f 0/30 Sq. Ft.: Value of Project $ 3 CO Permits CCF: Notary: Bonds Radon: o 6 Amount of/� &'d Permit: (41 d. �O --a -- der named above to construct the building or to install the equipment or device described in the applica- pertaining thereto and with the understanding that the work will be performed in compliance with any y have been submitted to and approved by the proper municipal authorities. This Permit may be revoked with such ordinances or if the plans are changed without authorization. A further condition upon which this tractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and e e., Nether shown on the plans or drawings or in the statements or specifications and that he assumes respon- p oyees. r 1 h4: AC (INSPECTOR) BY / ' e� permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ; plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. ility for all work done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER BY AUTHORITY C• MU »ING LECTRICAL 'LUMBING LOO G )w+ ner; of ; uilding MIAMI SHORES VILLAGE. D o PERMIT N? 6609 D FLORIDA Work to be performed under this P DATE ConfractortIs License NO. 195_x,: rchitect' <-r . ontractor. 'r Builder 3 $ + B ,egal )escription address of -'`' Value of Amount of iuildinig ae �' �'" " " Project $ Permit $ Lot Bl Subdi- vision I 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 terefor im strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans IrawingS, 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 Cite 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 ted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations atnit g to the work covered hereby whether shown on the plans or drawings or in the statements o ons and that he assumes responsibility for work one by his agents, servants or employees. Signedt SPECTOl 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 rtainizlg thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In acs Piing this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. - ONTRACTOR OR BUILDER BY AUTHORITY SEPTIC TANK AND DRAINAGE INSTALLATIONS - REPAIRS - CLEANINGS �. if. peptic Tank C'•,Jnc. 1123 EAST 23rd STREET HIALEAH P. O. BOX 1012 FLORIDA Phones: 88 -1114 - 88 -4955 Nights 3 -4775 AA SEPTIC TANK CO. I 1123 E. 23rd ► • � 88:111.4 Terms: Net — No discount )1iLVAra-- COMMERCIAL DRAINAGE SYSTEMS INSTALLED AND MAINTAINED CONCRETE GARBAGE RECEPTACLES UNDER GROUND, ABOVE GROUND CONCRETE CLOTHES POLES a_ *i MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 114 ® rip °� Permit No l `t 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 Registered Architect and /or En Employing Plumber's Name r No Street...___ No. Street Location and Legal Description Lot Block Subdivision. - Street and Number where work is to be performed—No State work to be performed and purpose of building (By New. Building Remodeling f ,e /e3 Street Addition Repairs._.._. No. of Stories. ___ Size Septic Tank Feet of Drain Tile Nature of Water Suppl Type of Tank Feet of Tank or Drain Field from Well Size of Soakage Pit Capacity Gals. Amount of Permit $ / .� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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 die Act. The undersigned agrees toonploy only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 3, ay ,: :g Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared STATE OF FLORIDA, COUNTY OF DADE. (Sig►) Master Plumber. to me well known, of the ae therein byyhhim who, being by me first duly sworn, upon oath deposes and says that he is the construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts are true. My Commission Expires Notary Public, State of Florida NO A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS ToBATH ss SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBE ,URINALS CATCH BASIN FLOOR DRAIN DRINKIN, FOUNT' NS (11 - i� '�+ — ' TOTAL FIXTURES / % .: ( ►. i " ; —V° 7 S' �.bi CHECK SEPTIC TANK SEINER DRAIN FIELD SOAKAGE FIT GREASE' - TRAP • DEEP WELL SPRKLR. SYSTEM. SWIM•G p�j J�• /' a ft c) 'i� ? —ad.= "" CONTR. LIST ryryryCONN. ^—"^� I tee.. / 0 0 52) ®® ° CHECK Size Septic Tank Feet of Drain Tile Nature of Water Suppl Type of Tank Feet of Tank or Drain Field from Well Size of Soakage Pit Capacity Gals. Amount of Permit $ / .� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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 die Act. The undersigned agrees toonploy only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 3, ay ,: :g Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared STATE OF FLORIDA, COUNTY OF DADE. (Sig►) Master Plumber. to me well known, of the ae therein byyhhim who, being by me first duly sworn, upon oath deposes and says that he is the construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts are true. My Commission Expires Notary Public, State of Florida NO A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE' PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING P NIIT Permit No. � Date / 4 8 Application is hereby 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 Registered Architect and /or Engineer Employing Plumber's Name No , Str °� No .��' � � � S Location and Legal Description Lot Block Subdivisions Street and Number where work is to be performed-No. Street State work to be performed and purpose of bislang (By Floors) New Building Remodeling— Addition Repairs— No. of Stories Size Septic Tank Type of Tank Capacity Gals, Feet of Drain Tile i Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well. Size of Soakage Pit Amount of Permit $ /1 -� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ■ under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above aabbo a desgibed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts are true. My Commission Expires Notary Public, Stat NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made .necessary by improper nc materials and /or workmanship. of Florida ce for inspection, or faulty TOTAL FIXTURES CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS. CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NEI CONTR. LIST -.—� CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM •G POOL coarse. LIST CHECK Size Septic Tank Type of Tank Capacity Gals, Feet of Drain Tile i Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well. Size of Soakage Pit Amount of Permit $ /1 -� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ■ under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above aabbo a desgibed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts are true. My Commission Expires Notary Public, Stat NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made .necessary by improper nc materials and /or workmanship. of Florida ce for inspection, or faulty Permit No 6, 0-1 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date. 42:-- .:. 7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi ed for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula ns 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.._ J4 1 dtics / No Street. .. Registered Architect and /or Engineer Employing Electrician's Name J' 47.1 TX/ e" No.... ... Street.:' : ,Subdivision. Street %� .daU Location and Legal Description Lot Block Street and Number where work is to be performedNo '1� / N °.....f..0. State work to be performed and purpose of building (By Floors) New Building ...._ Remodeling Addition o' .Repairs. No. of Stories Service Overhead Size Feeders Conduit. .Main Sw Underground Type of Installation -- Conduit. Tubing B.X.L .Metal Moulding.. . » ..............: » ... ..Amps .Main Fuses. .Amps Amount of Permit $ (Signed) »»......, Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his olbligarions 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 nub contractors em ployed 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•contractgrs, on work to be perf under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, } COUNTY OF DADE. es. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared.. ».,. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the...... ..» ............ .... ........... ».. »........ ».... of the above described construction, and he ` has carefully read the foregoing application, and that he did sign he same, and that all facts therein by him stated are true. My Commission Expires Notary Public, StaI of Florida NOTE: A reinspection fee of $1.00 will be made when such re °inspection is made necessary by improper nbtice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE•P•rS FIXTURES NO. LAN S REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ggACE Ht*TEp STRIP HEATER TOTAL L1t3T CLIST —�— —' CHECK ENT. SW. DIST. CAS. SERVICE TEMP. BERM PERM. MOTORS : 0.1 HP MOTORS 1.4 Hp NEON TRANS. RADIO TOTAL CONTR. LIST I CHECK Service Overhead Size Feeders Conduit. .Main Sw Underground Type of Installation -- Conduit. Tubing B.X.L .Metal Moulding.. . » ..............: » ... ..Amps .Main Fuses. .Amps Amount of Permit $ (Signed) »»......, Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his olbligarions 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 nub contractors em ployed 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•contractgrs, on work to be perf under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, } COUNTY OF DADE. es. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared.. ».,. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the...... ..» ............ .... ........... ».. »........ ».... of the above described construction, and he ` has carefully read the foregoing application, and that he did sign he same, and that all facts therein by him stated are true. My Commission Expires Notary Public, StaI of Florida NOTE: A reinspection fee of $1.00 will be made when such re °inspection is made necessary by improper nbtice for inspection, or faulty materials and /or workmanship. Permit No `f MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date Y I Sy 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 41- -&...4 Stree A. Registered Architect and /or - Engineer._.: C L ' ' Streir Employing Electrician's Name. G , C.. �,l yF �� .NoJ ._ _-e Location and Legal Description Lot -� Block Subdivision Street and Number where work is to be performed —No..: GJ /1 /j j � t Street State work to be performed a d purpose. of building (By Floors)_. s. .' :....• ` ^h..r.'4rrt New Building Remodeling Additio Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L Metal Moulding Amount of Permit $ ( (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) x 'xc: j' i - ,.-, � STATE OF FLORIDA, % y i % Master Electrician. COUNTY OF DADE. } U. (�jL yac Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG.. OUTLET IRON - OUTLET RANGE OUTLET RANGE ' CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. D1ST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -S HP NEON TRANS. - RADIO TOTAL CONTR. LIST �. CHECK All) Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L Metal Moulding Amount of Permit $ ( (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) x 'xc: j' i - ,.-, � STATE OF FLORIDA, % y i % Master Electrician. COUNTY OF DADE. } U. (�jL yac Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor Location and leg description of lot to be built on: Lot___- l Block Street and Number where work is to be done C ,99 No Street te) _"' 'U!! = JaWA) Subdivision 4 _, l 4, _ _ __$ f - - -- . State work to be done and purpose of building (by floors) r New Building Remodeling To be constructed of ___ Kind of foundation Estimated Total cost of improvements $ J Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications be sent to Zone cubage required oO. and for no other purpose. Addition Repairs No. of Stories Roof Covering___ /4. 451„ Amount of Permit $._ -_ a_ CS tuAta flan Cubage 3 7, 3 7 Size of Building Lot for said building. All notices with reference to the building and its construction may 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. 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 e is the of the above described construction, that he has carefully read the fore -ng application, and that he did sign the same, and that all facts therein by him staged ar ie. l(4� Permit No Date Disapproved Date ( Signed) Chainnan Member Member _..._._.. Council Approved Building Inspector Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE NOTE: A charge of $1.00 will be made for the Planning Board. A re-inspection fee of $1.00 will be charged materials and/or workmanship. Member Member Member Date Disapproved making corrections or changes to when such re- inspection is made Date this application after approval has been obtained from necessary by improper notice for inspection or faulty Job Addres Legal Deseripti Owner / Lessee Owner's Address 40/' E JD Contracting Co. ;— 1./ 'e,4e( 66/644-6 x Z''( Qualifier /9/ e b 13 ' Elope? ss# '� - -. #.19/69a Competency # RiqQ� e #107460glariciPel 'teat/Engineer Pert Type,(circle one) BUILDING EGECTR CAL PLUMBI DESCRIPTION re Ft. Estimated (va] ` N ING TO OWNER : YOU MUST RECORD A NOTICE OF OC+ MAY RESULT, IN YOUR PAYING TWICE FOR IMPROVEMENT ! TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER Oft +! t NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and .it on the attached addendum (if applicable).' I certify that all .1 z standards of all laWs regulating construction in this jur sd cti permits are required Ifor ELECTRICAL, PLUMBING, SIGNS, OWNER'S AFFIDAVIT: I certify that all the foregoing inf tion i be done in compliance with all applicable laws regulati g =: authorize the ,ye- namee. contractor to do the work stated Sign - ure o Date: A esdent Si Date: ,Lary as to Owner and /or Condo President tart' a ter ±sr tor :; NF Com misgton Es . Notary rim a. tote o FI c�! by Commission Expires p Dec. 1 r 199 Commission Expires Dec. I 19 Oond� ru Troy Fai Insurance Inc. .d Thru Tr* Fein as * * '�'' �r '' �4 � FEES: PERMIT ,Vii/ L7 RA N C.C.F. I S N ` APPROVED: Fire Ot Zoning Building Plumbin PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) /, Date 10/22/91 Job Address %J / / 401 N.E. 103rd Street Tax Folio// 100/ Legal Descriptio Owner / Lessee / Tenant Estate of Shirley Jensen Master Permit # Owner's Address 401 N.E. 103rd Street Phone 754 -7725 (AGENT) Contracting Co. S.E. FLA. ADVANCED ROOFING Address 15490 N.W. 7th Avenue, #203 Qualifier James Culleton SS# 263 - 45 4488 Phone 652 -6900 State# CC C041310 Competency # Architect /Engineer N/A Bonding Company N/A Mortgagor Permit Type (circle one): (BUILDING) ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIG?. N/A Address Address Addres4 Ins.Co.Reliance /Liberty Mutual WORK DESCRIPTION Re -Roof ara e . Tar & Gravel tear off, coin back with 30# felt base sheet, 3 -ply built -up tar & gravel, 3X3 eave drip, aluminum fiber coated. Also, repair's to overhand at flat tile pitched roof. Replace all rotten lumber as needed. Paint flat tile. Square Ft. lOsq . Estimated Cost $ 5,900.00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do vzrk a.: i -tallation 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 What all cork will 'e dons in compliance with all applicable laws regulating construction aid zoning. Furne more„ I authorize the above - named contractor to do the work stated. Sign:: *.0 a cf Owne and /or Date: i,: CUf V , Notary as to Owner and /or My Commission Expires: * * PERMIT FEE: APPROVED: Zoning Mechanical Cond ' President NOTARY PUBLIC STATE OF FLORIDA MY COMMISSION EXP. MAY 27,1995 BONDED THRU GENERAL INS. UND. Condo President * * * Fire SignAture of Contractor or Owner - Builder Date: Notary as to Contractor Egio -Bui •er My Commission Expires IC STATE OF FLORIDA * * * * N E MAY 27„A+995 ,6 EMAl, INS. MD. Other Plumbing v1 ctrical Engineering FLORIDA STATUTE s.713.135 Folio No. BUILDING PERMIT APPLICATION Owner's Name The Jenson Estate Owner's Address 401 N.E. 103rd Street . Fee Simple Titleholder's Name (if other than owner) . same Fee Simple Titleholder's Address (if other than owner) same City State Zip Contractor's Name S . E . FLA . ADVANCED ROOFING , CORP . Contractor's Address 15490 N.W. 7th Avenue , SUITE# 203 City Miami State Florida Zip 33169 Job Name The Jenson Property Job Address 401 N.E. 103rd Street City Miami Shores County Dade Legal Description Bonding Company N/A Bonding Company Address City State Architect/Engineer's Name N/A Architect/Engineer's Address Mortgage Lender's Name N/A Mortgage Lender's Address 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Signatur -- Signature ez-s 2-41 Owner or Agent (i ciuding contractor) Contractor Date /61 1' z .9/ Date NOTARY as to Owner or Anent 4• ,CUZ , "9 OTARY as to Contractor (jv My Commission Expires: My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA ROTARY PUBLIC STATE 1)F FLORIDA NY EMISSION EXP. MAY 27,1995 MY COMMISSION EXP. MAY 27,1995 CERTIFICATE of COMPEI 'IMP •Imo• UND. BONDED TMRl1 GENERAL INS. M. Contractor's State Certification or Registration No. CC C 0 4 1 3 1 0 Contractor's Certificate of Competency No. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores 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 The Jenson Estate Registered Architect andior Engineer N/A Date October 22 1991 No. 401 N.E ,Street 103rd Street Name and address of licensed contractor S.E. FLA. ADVANCED ROOFING 15490 N.W. 7th Ave #203 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 401 N • E • 103rd Street Re -Roof garage area, tar & gravel State work to be done and purpose of building (by floors), state exterior colors (submit samples) tear -off, going back 3 -ply built -up tar & gravel, 3X3 eave drip, 30* felt base sheet. Also repair's at tile roof overhangs. and for no other purpose. New Building Remodeling Addition Repairs X No of Stories 2 To be constructed of Kind of foundation Roof Covering tar & gravel/Tile Estimated Total cost of improvements 6 $ 5 ' 900 • 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to 401 N.E. 103rd Street The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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) j'L� `•.'� �—/-GZ I�r'� STATE OF FLORIDA COUNTY OF DADE. 1 ss. Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared James Culleton to me well known. and who, being by me first duly sworn, upon oath deposes and says that he is the Contractor/Qualifier of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Date Disapproved Date KIW 1A, ' I l � If • Read. Sworn to and Subscribed before me. (Signed) pONDEO THRU GENERAL INS. UND. Building Inspector My Commission Expire PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and.or workmanship. This Instrument Prepared By: Name Addres s .e /te j'� Permit Nil. NOTICE OF COMM`NCEMENT STATE OFAf1. COUNTY OF 777/9 1 r Clerk's Use Only Tax Folio No.)/ 3l6/50)3l 91R370900 1991 OCT 22 14:15 THE UNDER I an heeby certain Statutes, thefollowing real property, information is provided in this Notice of Commencement. )tion of property, and street address if 1. Description of property: (legal. din �-.1 available) p7- )3 ,/V242//6/ 2. General description of improvement: 3. Owner information a. Name and address: p ) .4)4-'7/ /I, /V5 /b. fie/ /GZ ���._ � u /� b. Interest in property: �;r� '1� c. flame and address of fee simple t it l.cho 1der (Lf other than owner) : /'/3 5 z, 1/ 5-- 4. Contractor: (name and address) S " 1C Db;/fi eI /e 5. Surety: a. Jame and address: b. Amount of bond$ Lender: (name and address) / ?V) (667' STATE OF FLORIDA COUNTY OF DADE 1 HEREBY CERTIFY that that Is r .1h o} • original file miniL office on A.D. WITNESS my band and official Seal, Clot ca Court BY 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7.,Florida Statutes: (name and address) D C. 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: (name and address) 9. Expiration date of notice of commencement (the expiration date is the date of recording unless a different date is specified) 9 e Sworn to all subscribed bcf:orc ne -7_,t- ,19 �j . (Sibnatude of Notary Public) y� X111[lG3 St_. notary's Name di Agy .f NOTARY PAi3LIC, STATE OF FI,���e �/71 � �• ' U Notary's Commission Expires: M YC(lM113 ONEXPIRES: oAlyI9,19�K, BONDED THRU NOTARY PUBLIC UNDJWTE44 ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY TO COMPLY WITH RECORDING REO,UIREi'rhTc, (Signature of Owner's Name / %A/ -tom S e / Owners Address JahnYers OWNERS PRESENT AD Lie JOB LOCATION (ST. OR AVE. Jcian trers 'GENERAL CONT" ACTOR ADDRESS BUILDING PERMIT N PERMIT FEE ZONE RE MR M NTH' FT. PLAN CUBE 370 j EST. DRAWINGS. SPECIFICATIONS RSTRICTiONS AND CUBS CHECKED BY-NEW CONSTRUCTION C tile I Terrazzo floors, s� DESCRIPTION piaster'watis and RIfiAIRB ALTERATI ADDITI;3N baths -3 bdrm.fil.iving room -dini r. o garage DE -... _ APPROVED EJECTED IPTION REFERRED TO CdUNCIL UB$t1TTD TO PLANNING AN Y ,'e BUILLNi3 Piet BUILDING INSPECTIONS INSPECTIONS IATE BY RE- INSPECT BY RE- I4SPECT BY FOUNDATION 9" J) DATE FEE TEMPORARY SERVICE a,,. BEAMS %$ LINTELS —1—,Sr £/. k_ $ SEWER FRAMING $ SOLAR HEATER MOTORS $ 141w —° /v-03J't Erli $ $ FINAL - .a.Ir` - DATE RE- INSPECT BY RE- INSPECT CLEAN-UP ROUGHING �.� "/� /0 ^ ���,j I" ^BYE/ r9 (�'� RE -INSP T BY PLUMBING P,ERMITS & INSPECTIONS CONTRACTOR 7 .1M '°`add ✓�+' - ,x,.,,r PHONE // - PERMIT NO. • 1 ¥ DATE / d `1.Z -aZ - .5/ /�(' FEE $ / 7 - } NEW BLDG. ALTERATION ADDITION REPAIRS / SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE a,,. $ SEPTIC TANK k_ $ SEWER RANGE CONN. $ SOLAR HEATER MOTORS $ GAS $ $ $ $ INSPECTIONS DATE RE- INSPECT BY RE- INSPECT BY . ROUGHING �.� "/� /0 ^ ���,j I" ^BYE/ r9 (�'� RE -INSP T BY TEMP..SERVICEk'',.� GAS It / II � �'S'aJ SEWER /� !)-4le'�[r SEPTIC TANK H. W. HEATER CONN Iiiit SOLAR HEATER RANGE CONN. FIXTURES FIX'P•!?RES & FINAL ELECTRICAL PERMITS & INSPECTIONS' CONTRACTOR L .C, •4...1 :,y. PHONE PERMIT NO. 179f, I DATE /® 1'1 FEE $ /,..ss 7 NEW BLDG. ALTERATION { ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE Q - fiAX.,}' a,,. H. W. HEATER CONN. $ c RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE -INSP T BY TEMP..SERVICEk'',.� !_.- ✓� ,.✓y..•.,• � �'S'aJ ROUGHING /� !)-4le'�[r H. W. HEATER CONN Iiiit RANGE CONN. FIX'P•!?RES & FINAL APPROVAL TO POWER CO. FOR SERVICE DATE 14C BY ,2 -/7-5-5 • MIAMI SHORES VILLAGE BUILDIN INSPECTION DEPARTMEN APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det filed statemen• of the plans and specifications herewith submitted for the build- ing or o h -ructure her i described This rilicatic is made in compliance and con 0' m ty w.th the Building Ordinance of Mia -ii Shores Village, or da, and all pro isions of the Laws t the State cf Fk.rid. all o d nances of Mi ni Shores Village and all rules and regu -a ion, of the Building Div i of .lam Sho. illage 1 '1 ,e o spied with, whether herein specified or not. A copy of approved plans and specificatimQ must be kei • at building durint progress of tl.e wcrk. Owner' Name and Address___._ John Meyers Registered Architect and /or Engineer Name rid address of licensed contractor. Date 12/6/54 No 3898 ,19 Street_. Biscf yne Blvd. Id -I zn Sh 'et :.til arks inc . Location and legal description of lot to be built on: 1'� 14 u 1 Ors Ltzko Lot "__ Block_ _- - --- Subdivision Street and Number where work is to be done - 401 N. State work to be done and purpose of building (by floors) l hot- n1oDr-ed.- POifted Butts; 4Ply Asph .lt & Grave ; G lv. ` ?_Shtngs,.__E ve_._Drtp - -- ti1G�.___SI'i_Sf 1:_,�'tC 2.._ __ and for no other purpose. 103 Street 1 -30# felt tincapoed; 1 -90" slate New Building_ __.._X__ _ _ _ Remodeling__ ____ _ __. Addition___ ___ __ _ Repairs_ _ _ _ No. of Stories. To be constructed of _ _ Kind of foundation Roof Coy -ring__ X -. Estimated ' -,tal cost of improvements $_ 1237.00. Amount of Permit Zone ^ubage required_ __. _.Plan Cubage Distance to next nearest building __Size of Building Lot Maximum live load to be borne by each floor 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 unde signed appli ant for the bulding permit does hereby certify t'iat he understands and accepts his .•bligations as an employer of 1 bor under he Florida Workmen's Compensation Act being S ,tion 5966 Coi p led Gen al Laws of Florida P r Sipple dent, and h s compl ed w :th he prov'eons thereof, and will require s.milar comp fiance from all contractors or sub-eontr 1 plo 'ed by him in the wo k to be p if med under th s pern it and ill post or cause to be posted f• ' nspection on the site . e work h public note e or •otices as are requir d by the Act. The u. d. r ign .d agrees to employ only sue Mr. o�,� . orp der this permit as are licensed by M am, Shores N. ih: ge. Remarks - ( Signed) - STATE OF FLORIDA, COUNTY OF DADE. j Ss. Before me, the undersigned authority, peared -- _ -- -- a notary public, duly authorized to administer oaths c.nd take acknowledgments, personally op- to me well known, and who, being by me first d ly cworn, upon oath deposes and says that he is the of th abov de ,c ibed • istruction t h has carerrally read the f oregoing application, and that he did sign the same, and that all facts therein by him stated are tr ie. Permit No Disapproved (Signed) ____ Chairman Member Member Read, Sworn to and Subscribed before me. Notary Public State of Florida My Commission Expires_ PLANNING BOARD - Member _ Member Member . Date Disapproved making corrections or changes to this application tfter approval his been obtained from when such re- inspection is min e necessary by improper notice for inspe_•bor or fa, Ity Council Approved- _ - NOTE: A charge of $1.00 will be made for the Plane ng Board ter %oA reins tires —lee of $1.00 will be charged workmanship. __-DATE Date MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No P9/ Date t ....A >s— Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s bmitted 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 Q.O/' 4/ Registered Architect and /or Engineer Employing Electrician's 4.r.C, "44 / a O.T..!Y..�� /.4 ,._. /.IVG r No,s 1� " A' 41, r Street No Street Location and Legal Description Lot 1)4447' Block Subdivision Street and Number where work is to be performed —No '9". / 12`3 «7 Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Overhead Service Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps Type of Installation -- Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ ,�.t�„ '[� (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands accepts his obligations as an employer of Tabor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Ija s of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractor or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. SS. Muter Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty mate ji and /or workmanship. SWITCH OUTLETS LIGHT OUTL�EEJTS PLUG RECE•P'T'S FIXTURES NO, LAMPS REFRIG. OUTLET IRON - OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST �.l 1/� / J / / / L r CHECK 9 ENT. SW. GIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO. TOTAL CONTR. LIST / / / /�r/� /V V /y. rL \4� CHECK Overhead Service Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps Type of Installation -- Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ ,�.t�„ '[� (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands accepts his obligations as an employer of Tabor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Ija s of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractor or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. SS. Muter Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty mate ji and /or workmanship. y2_ IZA *i,1 ,3.7.E Otis %,060 -74L110,‘? 2= tJ 13: 3o ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of Building PERMIT N9 624 DATE Contractor's License No. 195-- Work to be performed under this Permit Architect Contractor or Builder Legal Lot Description y Bl. Address of Building Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans oawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. " Signed- INSPECTOR In consideration of the issuance to me of this permit I agjee` 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. BY CONTRACTOR np RTTTT T1PR nv 11 rrmv nrmv ,UILDING ;LECTRICAL 'LUMBING OOFING Iwner of uilding rchitect ontractor r Builder egal Lot escription ddress of uilding MIAMI SHORES VILLAGE, PERMIT N? 7508 FLORIDA DATE Contractor's License No. Work to be performed under this Permit_ 195 `' Bl. Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application :refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, -awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any rte 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 -anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations rtaining 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 me by his agents, servants or employees. Signed • -i INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hepunder in compliance with all ordinances and regulations :rtaining thereto and in strict conformity with the plans, drawings, statementta' or specifications submitted to the proper authorities of Miami Shores Village. r accepting this permit I assume responsibility for all work done by either; myself, my agent, ser4ant or employee. f CONTRACTOR OR BUILDER BY AUTHORITY 17 BUILDING ELECTRICAL PLUMBING ROOFING ❑ MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 6085 DATE Contractor's License License No. Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Bl. Lot Address of Building •'r f Subdi- vision Value of Project $ { Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed BY • INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 6 apliR6. BUILDING ELECTRICAL PLUMBING ROOFING LJ C MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 6127 DATE 195 Contractor's License No. Work to be performed under this Permit Owner of Building Architect Contractor or Builder C.. Legal Lot Description Bl. Address of Building Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans 'drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work r done by his agents, servants or employees. J f Signed. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered 1-reunder 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, servan( or employee. CONTRACTOR OR BUILDER BY AUTHORITY 6 BUILDING ❑ ELECTRICAL H PLUMBING H ROOFING ❑ II MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 10740 Date Contractor's License No. 19 -_:._. Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description Bl Address of Building Subdi- vision Sq. Ft. Value of a 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed • (INSPECTOR) BY In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER BY AUTHORITY 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. Owner's Name and Address. 4: Registered Architect and/or Engineer Name and address of licensed contractor .A1.1.1_ %-faSI X. Location and legal description of lot to be built on: Lot__r_if.°_ et.ya e9' Block r 911- Subdivision e"rar .L k e Street and Number where work is to be done %121. ,l �.`� -SI/- State work to be done and purpose of building (jly- Aeers)... &f.. '- .:.._- Cit.e6 iV7 ... . New Building_ . Remodeling Addition To be constructed of Kind of foundation.. . Estimated Total cost of improvements $ �t O, 0 D _Amount of Permit 8.. L Zone cubage required. Plan Cubage_.___ - -_ _ - - -. _ -- _-- _ - -_ -_ ,..__._.___ Distance to next nearest building_ -- _,. :_ Size of Building Lot___ Maximum live load to be borne by each oor... _ _.._.._.._.. �._. _.. I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may I be sent to__ a 02 1 S '' ,vv✓' ii".1��t ,197 HF /Pa Tt and for no other purpose. Repairs No of Stories Roof Covering 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 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance frgin 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 f r lion on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such 4 u 'onto:; ors, on work to • performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. J 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 Nor Disapproved __ (Signed) . Date Budding for Chairman ..._- Member Read, Sworn to and Subscribed before Notary Public, State of Flori da MyCommission Expires.-_-.__.._..- ..... ......_ ..._...__._ ________________ PANNING BOARD_.,_..._..._...- __- _.___- ____._.____-_DATE I 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. I J. T-- MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date l't . -s.4 — 4. 11 JersSet‘.. .19.. Owner's Name and Address KC. M sk...e6■ V- No. 4° I Street___N_Lg • .i 0.3..!.... --1. Si' . Registered Architect and/or Engineer Name and address of licensed contractorl4 VS TR. AO ... - Ll. a yD Ca Ce. P nort- A, Tlq. hI._ S . It• A at . Location and legal description of lot to be built on: Lot_______ Block____...._ Street and Number where work is to be dcme . E. t�3 g,"17 State work to be done and purpose of Wilding (by floors) TLC- roc. S f2 714_ irac. _ and for no or purpose. New Building Remodeling_ Addition Repairs . No. of Stories To be constructed of Kind of foundation_ Roof Covering Estimated Total cost of improvements $ 'ISO — .40 Amount of Permit $.... — . ...0 Zone cubage required__ Plan Cubage Distance to next nearest building Size of Building Lot__ Maximum live load to be borne by each floor _ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to__ ------ — The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed)ir gb- d'Ods. 4.$ LLD See 6. no ?, STATE OF FLORIDA, COUNTY OF DADE. j s's• 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. f g. . c) -7 4 c... r --...:. Permit No j Date. -1_ -__ Read, Sworn to and Subscribed before me. Disapproved , 1 -c..7 , Date Q _ .. _. ____ ..... __ . ( Signed) ......C.".. (---N-1--c. - . . . Notary Public, State of Florida Buil. .: Inspector My Commission Expires_ f 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. METROPOLITAN DADE COUNTY Building and Zoning Building Permit No. PERMIT NO. TYPE OR PRINT APPLICANT FILL INSIDE HEAVY LINES ROOFING PERMIT APPLICATION OWNER Mx. Martin V. Jensen TEL NO. MAIL ADDRESS 1401 N.E. 101 St. Miami Short BUILDING CONTR. MAIL ADDRESS ARCHITECT ENGINEER NYSTRAND -LLOY 178 S.W. CORP. 17th Ave. FOR OFFICE USE ONLY INSPECTION RECORD LEGAL- LOT NO - BLOCK NO. SUBDIVISION OR METES & BOUNDS P B & PAGE NO SEC. TWP. RGE STREET ADDRESS OF JOB 401 N. . 101 St. LOT SIZE ( SURVEY ATTACHED? LOT STAKED? PRESENT USE (VACANT, OR NO. OF BUILDINGS AND USE OF EACH) I HEREBY MAKE APPLICATION FOR A PERMIT TO APPLY NEW 0 REPAIR 0 REPLACE A ROOF ON THE FOLLOWING TYPE STRUCTURE: RESIDENTIAL KCOMMERCIAL 0 INDUSTRIAL 0 FOR THE FOLLOWING SPECIFIC OCCUPANCY AND USE TYPE OF ROOF Built up NO. OF PLYS 5 FLASHING METAL TYPE gal., TIN CAP SPACING 12t1 TYPE SURFACE OF DECK flat WT. OF FELT EACH PLY 1511). 32 /12 GAUGE -26 ROOF PITCH NAIL SIZE & LENGTH 11/2" DRIP STRIP METAL TYPE gravel s STIDTH GAUGE GRAVEL STOP METAL TYPE gel* WIDTH 3" GAUGE NO. OF SQUARES 14 EST COST $ 1+50 00 I UNDERSTAND THAT IN SIGNING THIS APPLICATION, I AM RESPONSIBLE FOR THE SUPERVISION AND COMPLETION OF THE CONSTRUCTION IN AC- CORDANCE WITH THE PLANS AND SPECIFICATIONS AND FOR COMPLI- AN TH ALL FEDERAL, STATE AND COUNTY LAWS APPLICABLE. CONTRACTOR (•UALIFIER) OR 0 NE- -BUILD WITNESS (CLERK) DATE ACCEPTED: DRY -IN ' WT. FELT 'OVERLAP NAIL SIZE SPACING DRIP STRIP METAL GAUGE SIZE NAILING GRAVEL STOP METAL GAUGE SIZE NAILING FLASHING TYPE WT VALLEY METAL GAUGE TILE- TILE WETTED OVERLAP MORTAR SURFACE FINAL- SURFACE WORKMANSHIP TO CODE DRY -IN INSP FINAL INSP. DATE TOTAL SQUARES FEE ADMINISTRATION DATE PROOF OF OWNERSHIP CHECKER VIOLATIONS- - CHECK: CHECKER DATE CONTR. CERT. NUMBER CLASS CHECKER AN AUTHORIZED REPRESENTATIVE OF THE DIRECTOR, DADE COUNTY BUILDING AND ZONING DEPARTMENT AND ALL FEES PAID AND RECEIPT ACKNOWLEDGED IN THE SPACE PROVIDED. BY CONDITIONS UNDER WHICH APPROVED.- APPROVED DISAPPROVED REASON ZONING - STRUCTURAL 'PLUMBING ELECTRICAL MECHANICAL 123.03 -5 INSPECTOR'S COPY MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 4? Date.......» Application is hereby 'made for the approval o 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 Mid 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 Registered Architect and /or $ eer....... 6._ Employing Electrician's Name Y �� ° ' No......._... S� Street.:. Location and Legal Description Lot Block Subdivision., Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building ..Remodeling .Addition Repairs. :.No. of Stories t • No....... »..._ W (/ Street... /.L..... j r Service Underground Size Feeders..... Conduit. .Main Sw .Amps Maur Fuses. ... »...........Amps Type of Installation -- Conduit. Tubing , B.X.L Metal Moulding ...... Amount of Permit $ ...» (Signed) L ». ».. The undersigned applicant for this building permit does hereby certify that he understands and accepts labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or sub..ntractors 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 ,erformecl under this permit, as are licensed by Miami Shores Village. (` - .rte... Electrical Inspector. obligations as an employer of da Permanent Supplement, and (Signed).... STATE OF FLORIDA, COUNTY OF DADE. j ss' 1 t Before me, the undersigned authority, a notary public, duly authorized to administer oaths appeared to me well known, and who, being by me fir duly sworn, upon oath deposes and says that he is the of the above described construction, and he l as carefully read the foregoing application, and that he therein by him stated are true. d Master Electrician. and take acknowledgments, personally did sign the same, and that all facts 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 OUTLETS LIGHT OUTLETS PLUG RECE•P•T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. $rACE -- HEATER STRIP HEATER TOTAL CONTR. LIST - , T- CHECK ENT. SW. 01ST. CAS. SERVICE TEMP. SERVICE PERU. MOTORS 0.1 HP MOTORS NEON 1.0 HP TRANS. RADIO TOTAL. CONTR. LIST A. e „.„ - _ - -- CHECK Service Underground Size Feeders..... Conduit. .Main Sw .Amps Maur Fuses. ... »...........Amps Type of Installation -- Conduit. Tubing , B.X.L Metal Moulding ...... Amount of Permit $ ...» (Signed) L ». ».. The undersigned applicant for this building permit does hereby certify that he understands and accepts labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or sub..ntractors 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 ,erformecl under this permit, as are licensed by Miami Shores Village. (` - .rte... Electrical Inspector. obligations as an employer of da Permanent Supplement, and (Signed).... STATE OF FLORIDA, COUNTY OF DADE. j ss' 1 t Before me, the undersigned authority, a notary public, duly authorized to administer oaths appeared to me well known, and who, being by me fir duly sworn, upon oath deposes and says that he is the of the above described construction, and he l as carefully read the foregoing application, and that he therein by him stated are true. d Master Electrician. and take acknowledgments, personally did sign the same, and that all facts 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. s lik e '4 APPLICATION FOR ELECTRICAL PERMIT Permit No Date».. -fir ._ :.- » -.�.». . /? . 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. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Owner's Name and Address. Registered Architect and/or Eng• eer Employing Electrician's Name.... le Location and Legal Description Lot No Street and Number where work is to be performed —No ee-!" ® J State work to be performed and purpose of building (By Floors) New Building.. .Remodeling ..Addition No /c241 /1.:.LStreet...l. Street Block Subdivision c71° ... ......_.... ».Street. / 2 ; .Repairs. No. of Stories. Service Overhead Size Feeders. Conduit.. .Main Sw .Amps .Main Fuses _Amps Type of Installation — Conduit. Tubing .B.X.L .Metal Moulding Amount of Permit $ (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work Such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed un • er this permit, as are licensed by Miami Shores Village. - Ele =, ' - . ector. obligations as an employer of da Permanent Supplement, and (Signed COUNTY OF DADE. } ss. S'P'ATE OF FLORIDA, Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE; A reinspection 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 OUTLETS LIGHT OUTLETS PLUG RECE•P•T•B FIXTURES NO. LAMPS REPRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER NEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. - DIST. CAB SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL LIST r CHECK Service Overhead Size Feeders. Conduit.. .Main Sw .Amps .Main Fuses _Amps Type of Installation — Conduit. Tubing .B.X.L .Metal Moulding Amount of Permit $ (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work Such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed un • er this permit, as are licensed by Miami Shores Village. - Ele =, ' - . ector. obligations as an employer of da Permanent Supplement, and (Signed COUNTY OF DADE. } ss. S'P'ATE OF FLORIDA, Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE; A reinspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date..._..... ... .. p 1924 Owner's Name and Address .J eU S.0.11...Rarli. i.V —:11fe chi .... ...»......_. No........ 01 Street». I.>:. .. Registered Architect and /or Engineer » . »... »....» - ... ».. - ree s2 2.e.....2.•R112C2e2121./21222.22 Name and address of licensed contractor Andrews ews Roo ,i ng_ , Imp.. „» fs . 4 00 E,, »,,1, ; Location and legal description of lot to be built on: ..... — Block. ».» ....._.» Subdivision Street and Number where work is to be done 229 N. W. 111th lg.' , State work to be done and purpose of building (by floors). r�..�...�.•..Sb wE.era].eak ng in 4 place aver .eay.e.s.._. _repl.a.ce»rotted waa.d. . 100 _ s a ft. ___._.. » ._......_.»»... ....._and for no other purpose. New Building Remodeling. Addition Repairs X No. of Stories...l .._ _ _....... To be constructed of Kind of foundation...... ». Roo$ Covering • Sh . Tile „ Estimated Total cost of improvements $.....4 7 5 , 0 0 _.. ___..._Amount of Permit S..» . 5.00 Zone cubage required _......__..._.__.._.. ___.. _. plan Cubage Distance to next nearest building. ___. _ ..Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to Andrews Roofing Imp. Co. 4300 E. 11th Ave. Hia. 33013 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Iabor 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 th work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcw,h tract op, on woylt to performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared .. 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 star are trues. Permit No. 5-6. Disapproved (Signed) Date.__S Read, Sworn to and Subscribed before me. Date uildingi' spector Notary Public, State of Florida My Commission Expires PLAN G 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. COUTEM.11i)e_ Li' A, &L C 066-z4 IAMI SHOES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FC3R LIILDING PERMIT • Application is hereby made for the approN,a1 of the detailed staternent of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in conipliance 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 'Coinplied with whether herein specified or not A copy of approved plans and specifications must be kept at building during plogress of the work. Date Owner's Name and Address Registered Architect and/or Engineer 40.404",_, Name and address of licensed contractor ang"7-474X604"/ Vf""Ce" .Z...7/26? /16149-er-_,e Location and legal description of lot to be built on: Lot_. /1:11t1:10 Block No. fiubdivision -2/(.4.641.614J Street and Number where work is to be done 41e1/ Nrix: State work to be done and ose of building (by floors) Drefet.Z. .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 $_____aaga_____A,mount of Permit $,.. e7,52:1_ Zone cubage required. _Plan Cubage Distance to next nearest building Size of Building Lot__ Maximum live load to be borne by each floor Thereby submit all e plans and cifications for 'el building. All notices with reference to the building and its construction may CZT,1014■/ Li2,C■■ be sent The undersigned applicant for this building permit does hereby certify that he understands of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen and complied with the provisions thereof, and will require similar compliance from all in tl6 work to be, performed under this permit; and will post or cause to be posted for • or otices as are required by the Act. The undersigned agrees to employ only such prmit, as are licensed by Miami Shores Village. Xtemarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss' .... Y..- a • a .ts his obligations as an e ployer of Florida, Permanent S plement, s or sub-contra s em yed by him on the site of the o su • public notice k. 4 e ■ . '. 410111k/ .0*4 ed under this ,..-- .------,,, ----,.. 41111■/.4....t' _....• Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aelmowledgments, personally ap- peered to we well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ...... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Disapproved (Signed) _ Date Date Buil g Insp Chainnan Member Member Council Approved '7 7-- Read, Sworn to and Subscribed before me. P NING BOARD Notary Public, State of Florida My Commission Expires :DATE Member Member ________ Member 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 $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date \ 1� -` t3 Job Address °-\e\ • \cam tea' Tax Folio Legal Description Ifistorlcally Designated: Yes" No Owner/Lessee / Tenant r$b��� 'VA t ':c Master Permit # Owner'S Address Uc1 Cog Co. cam° - Quali r \4®i-vr �, ‘— ®A.:VC1 State # ` C—C. oS (Li °Z Municipal # Competency # Ins. Co. i F- - w . %u' tO iw Architect/Engineer Addr s Bonding Company 4I Address Mortgagor Kill II 1 Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANIC ROO PAVING FENCE SIGN l WORK DESCRIPTION ' $-,G - � i �► -fir '- '' ' , 4- t-b' \ ® �1� �tL — � ®� k7k\t�1` ' '� `4 c --C. • Phone Address 1`1".-e SS# }- Phone ,SZ -- Square Ft. `\e=5.c1N Estimated Cost (value) ®c..> 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 rel ating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFNG and MECHANICAL WORK. OWNER'S AFI IIAVIT: I certify that all the foregoing information is accu* laws regulating construction and zoning. Furth rmore, I authorize the above Signature of owner and/or Condo Presi a Date FEES: PERMIT APPROVED: Zoning Mechanical RADON Building C.C.F. and that all wore be done in compliance with all applicable ed con' : °t to the work stated. Date tractor or Owner - Builder Date sion Expires: 3 ® °ms's NOTARY Electrical Co TOTAL DUE I �• Plumbing Engineering NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: 95R4 134-6 1 1995 OCT 11 11:1E COUNTY OF DADE: ,, THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with r Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: H ° N • - \ a ST TA \brA 1 k\ -F� 2. Description of improvement: -y �L -rte -r\LE ■wiz \ \..mt; " \'M1 T . 3. Owner(s) name and address: �'�� `� ��T \44.7 Interest in property: 1 -t Name and address of fee simple titleholder: 4. Contractor's name and address: '° - ' L "4t"-s,R -m=•eS • \ \s'L 6.µA . 5. Surety:(Payment bond required by owner from co ractor, if any) Name and address: VA �. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida State, Name and address: t 8.1n addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Se tion 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Comm ncement: (the expiration date is 1 year from the date of recording unless a different date i j • 1 ified) ' S Signature of • ner v 11 Print Own =rs Name��� Sworn to and subscribed before me this 1 c� day of be--7 Notary Public Print Notary's Name My Commission Expires: ±: 4 f „RF • wary 'V,;c Hii.DA MORELLO M� C• m..11 ax ;•..une 7, 1996 Boa,,, tsia LC 206611 LORIDA, COUNTY OF DADE this is a true g6py/of the O:+ Prepared by: NNL.1.7, R. Address: k3'?..a N!• \ \� tkl%AA 123.01 -52 2/93 A 1 METRO-DADE METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING PRODUCT CONTROL NOTICE OF ACCEPTANCE Lifetile Corporation 200 Story Road Lake Wales FL 33859 -0632 BUILDING CODE COMPLIANCE OFFICE SUITE 1603 METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI. FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 PRODUCT CONTROL SECTION (305) 375 -2902 FAX (305) 372 -6339 Your application for Product Approval of: Nail On Mortar or Adhesive Capri Tile under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: Redland Technologies, The Center for Applied Engineering, Inc., and Atlanta Testing & Engineering has been recommended for acceptance by the Building Code Compliance office to be used in Dade County, Florida under the specific conditions set forth on pages 2 et. seq. and the Standard Conditions on page 3. This approval shall not be valid after the expiration date stated below. The Office of Code Compliance reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any ammendments to the South Florida Building Code be enacted affecting this product or material. The Building Code Compliance Office reserves the the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to mee the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.:95- 0316.04 (Revises No.: 94- 0914.23) Expires:06 /14/98 _ Raul Rodfiguez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above. Approved: 06 /14/95 s y anger, Director Building Code Compliance Dept. Metropolitan Dade County PRODUCT CONTROL•NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL Applicant: Lifetile Product Control No.: 200 Story Road Lake Wales, FL 33859 Approval Date: Expiration Date: Category: Prepared Roofing Sub- Category: Tile Type: Nail- on/Mortar Set/Adhesive Set Sub -Type: Concrete System Description 95- 0316.04 JUN 1 4 1995 JUN 1 4 1998 Lifetile is a member of the Boral Group and is a national producer of extruded concrete tile in California, Texas and Florida. Lifetile manufacturers concrete roof tile for nail -on, mortar set and adhesive set applications. All tile is extruded under high pressure in individual molds with the exposed tile surface finished with a cementitious material colored with synthetic oxide additives. All tile is 'cured' prior to shipping to achieve maximum strength. This Product Control Approval relates to Lifetile's "Capri; Tile" low tile profile. Refer to appropriate Product Control Approvals for other tile profiles. Lifetile sells tile systems through local, wholesale distribution. All profiles have matching trim pieces used for rake hip, ridge hip, and valley terminations. Tile system accessories such as ventilation systems. flashing systems and birdstops are also available. These accessories are manufactured for all profiles and form a part of this Product Control Approval. Lifetile's "Capri"' Tile" roof tile has been tested in compliance with the South Florida Building Code requirements for concrete, nail -on, mortar set and adhesive set tile applications. The minimum roof slope for Lifetile's "Capri"' Tile" nail -on, mortar set or adhesive set tiles shall be 2 ":12 ". See the "Profile Drawing" section in this approval for the "Capri" Tile" profile drawing. The Lifetile "Capri' Tile" tile profile has been tested for both wind characteristics and static uplift performance, therefore, any consideration for installation shall be done as a 'Moment Based System'. Data for attachment calculations is noted in Tables 1 through 4 of this approval. Contact: Dave Faulkner Technical Services Manager 200 Story Road P.O. Box 632 Lake Wales, FL 33859- -632 (813) 676 - 9405 Raul Rodriguez Product Capri" Tile Trim Pieces Product Control No.: 95- 0316.04 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product Dimensions Specifications Description 1= 17" PA 112 Low profile, interlocking, high w = 123/8" pressure extruded concrete roof tile '1 " thick equipped with two nail holes and double roller ribs. For direct deck or battened nail -on, mortar or adhesive set applications. 1= varies w = varies varying thickness PA 112 Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Raul Rodriguez Product #30 Felt #43 Coated Base Sheet Mineral Surface Cap Sheet Product Control No.: 95- 0316.04 TRADE NAMES OF PRODUCTS MANUFACTURED OTHERS Dimensions N/A N/A N/A Lenzingtex -ZB 140 59" x 164' roll Underlayment 22 lbs/roll Rainproof 11 Ice and Water Shield Mopping Asphalt Flashing Cement 30" x 75' roll 36" x 75' roll or 60" x 75' roll 36" x 75' roll N/A N/A Test pecifications ASTM D 226 type 11 Product Desdription. Saturated organic felt to be used as a nailed anchor sheet. ASTM D 2626 Saturated and coated organic base sheet for single or double ply underlayment. ASTM D 249 Mineral surfaced asphalt roll roofing for use as a top ply in a double ply underlayment system. PA 104 Single ply, nail -on underlayment. PA 104 • Single ply, nail -on underlayment with 2" self - adhering top edge. PA 103 Self - adhering underlayment for use as a top ply in a two ply underlayment system with approved #30 or #43 as the base layer. ASTM D 312 type Ill or IV ASTM D 4586 4 Asphalt for bonding a mineral surface cap to a mech. attached base sheet in a double ply underlayment system. Cut back, asphalt based, asbestos free, fiber reinforced, trowel grade cement for repair and flashing applications. Manufacturer generic generic generic Lenzing Performance, Inc. PCA #94- 0527.05 Protect -O -Wrap, Inc. PCA #94- 0714.01 W.R. Grace Co. PCA #92- 1116.01 Raul Rodriguez generic generic Product Control No.: 95- 0316.04 • Test Product Product Dimensions Specifications Description Manufacturer Asphalt Primer N/A ASTM D 41 Cut back, asphalt generic based coating used to facilitate bonding of dissimilar materials. Roofing Nails Tin Caps Wood Battens Tile Nails Tile Screws min. 12 ga. with 3 /g' head min. 32 ga. min. 1s /8" o.d. max. 2" o.d. PA 114 Appendix E PA 114 Appendix E Annular ring shank, hot dipped, electro or mechanically galv. roofing nails for use in underlayment attachment. Corrosion resistant circular disc for use in underlayment attachment vertical Wood Preservers Salt pressure treated min. 1" x 4" Institute LP - 2 or decay resistant horizontal lumber battens min. 1" x 4" for use with vertical battens or min. 1" x 2" for use alone min. 8d x 21/2" or min. 10d x 3" #8 x 21/2" long 0.335" head dia. 0.131" shank dia. 0.175" screw thread_ diameter PA 114 Appendix E PA 114 Appendix E generic generic generic Corrosion resistant, generic screw or smooth shank nails. Corrosion resistant, coated, square drive, galvanized, coarse thread wood screws generic Roof Tile Mortar N/A PA 123 Prepared mortar mix Bermuda Roof ( "TileTiteT "' ") designed for mortar Company, Inc. set roof tile PCA #94- 0614.01 applications. Roof Tile Mortar N/A PA 123 Prepared mortar mix Quikrcte Constructio ( "Quikrcte® Roof designed for mortar Products Tile Mortar #1140") set roof tile PCA #94- 0808.01 applications. 5 Raul Rodriguez Product Roof Tile Mortar ( "BONSAL® Roof Tile Mortar Mix ") Roof Tile Adhesive ( "Polypro® AH 160 ") Hurricane Clip & Fasteners Valley Flashing Drip Edge Dimensions N/A N/A • Test Specifications PA 123 Product Control No.: 95- 0316.04 Product Description Prepared mortar mix designed for mortar set roof tile applications. See PCA Two component polyurethane adhesive designed for adhesive set roof tile applications. Clips PA 114 min. %z' width Appendix E min. 0.060" thick Clip Fasteners min. 8d x 1W min. 26 ga. min. 16" width min. 26 ga. min. 2" face flange min. 2" deck flange • ASTM A 525 Corrosion resistant bronze, aluminum, stainless steel, galvanized steel or plastic attachment clips for supplemental tile attachment. Clips are installed with corrosion resistant roofing nails compatible with the clip. Galvanized steel valley flashing PA 111 Galvanized steel drip edge 6 Manufacturer W.R. Bonsai Co. PCA #94- 0628.03 Polyfoam Products, Inc. PCA #94- 0401.01 Raul Rodriguez generic generic generic .r Test Agency Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Enigneering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. TEST REPORTS Test Identifier 7161 -03 Appendix III 7161 -03 Appendix 111 94 -084 94 -060B 25- 7094 -1 25- 7094 -7 25- 7094 -4 25- 7183 -1 25- 7183 -3 25- 7214 -2 7 Product Control No.: 95- 0316.04 Test Name /Report Static Uplift Testing PA 102 Static Uplift Testing PA 102(A) Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 101 (Adhesive Set) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck, 5/8" plywood) Static Uplift Testing PA 102 • • (4" Headlap, Nails, Battens) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck, 15/32" plywood) Static Uplift Testing PA 102 (2 Quik -Drive Screws, Direct Deck) Static Uplift Testing PA 102 (2 Quik -Drive Screws, Battens) Static Uplift Testing PA 102 (I Quik -Drive Screw, Direct Deck) Date Dec. 1991 Dec. 1991 May 1994 March, 1994 Oct. 1994 Oct. 1994 Oct. 1994 Feb. 1995 Fcb. 1995 March, 1995 Raul Rodriguez ,a Test Agency The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. Atlanta Testing & Engineering. Test Identifier 25- 7214 -6 7161 -03 Appendix I1 Letter Dated Aug. 1, 1994 P0631 -01 P0402 Project No. 307025 Test #MDC -76 R1.894 R2.894 R3.894 8 Product Control No.: 95- 0316.04 Test Name/Report Static Uplift Testing PA 102 (1 Quik -Drive Screw, Battens) Wind Tunnel Testing PA 108 (Nail -On) Wind Tunnel Testing PA 108 (Nail -On) Wind Tunnel Testing PA 108 (Mortar Set) Withdrawal Resistance Testing of smooth vs. screw shank nails Wind Driven Rain PA 100 Physical Properties PA 112 Da e March, 1995 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Oct. 1994 Aug. 1994 Raul Rodriguez SYSTEMS Deck Type: Wood, Non - insulated Deck Description: New Construction 1941" or greater plywood or wood plank. SYSTEM A: Counter -Batten Application Slope Range: Product Control No.: 95- 0316.04 2 ":12" to 7 ":12" Note: Counter - Battens, as noted below, are required for slope range 2 ":12" to less than 4 ":12" and are optional for slopes of 4 ":12" to 7 ":12 ". For slopes exceeding 7 ":12 ", refer to System C. Underlayment: Install underlayment system in compliance with Dade County Application Standard PA 118. Vertical Battens: Install vertical battens in compliance with Dade County Application Standard PA 118 Horizontal Battens: Install horizontal battens in compliance with Dade County Application Standard PA 118. Roofing Tile: Install tile in compliance witl; Dade County Application Standard PA 118. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re -roof applications, I3 /3_" plywood is an acceptable substrate. 9 Raul Rodriguez Product Control No.: 95-0316.04 SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction '942" or greater plywood or wood plank. SYSTEM B: Direct Deck Application Slope Range: 4 ":12" to 7 ":12" Note: System B is only acceptable in this slope range. For slopes less than 4 ":12 ", refer to System A. For slopes in excess of 7 ":12 ", refer to System C. Underlayment: Roofing Tile: Comments: Install underlayment system in compliance with Dade County Application Standard PA 118. Install tile in compliance with Dade County Application Standard PA 118. (See "Data for Attachment Calculations" included in this Approval.) 1. For re -roof applications, "/32" plywood is an acceptable substrate. 10 7'1172%`2� Raul Rodriguez Product Control No.: 95- 0316.04 SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction 19/32" or greater plywood or wood plank. SYSTEM C: Horizontal Batten Application Slope Range: 4 ":12" or greater Note: Horizontal battens, as noted below, are required for slopes in excess of 7 ":12" and are optional for slopes of 4 ":12" to 7 ":12 ". For slopes less than 4 ":12 ", refer to System A. Underlayment: Install underlayment system in compliance with Dade County Application Standard PA 119. Horizontal Battens: Install horizontal battens in compliance with Dade County Application Standard PA 119. Roofing Tile: Install tile in compliance with Dade County Application Standard PA 119. (See "Data for Attachment Calculations" included in this Approval.) Comments: 1. For re -roof applications, 15/3_" plywood is an acceptable substrate. Raul Rodriguez Product Control No.: 95- 0316.04 SYSTEMS (CONTINUED) Deck Type: Wood, Non - insulated Deck Description: New construction 19/3_" or greater plywood or wood plank. SYSTEM D: Mortar or Adhesive Set Application Slope Range: 2 ":12" to 7 ":12" Note: System D. is only acceptable in this slope range. For slopes in excess of 7 ":12 ", refer to System C. Underlayment: Roofing Tile: Comments: Install underlayment system in compliance with Dade County Application Standard PA 120. (See System Limitation #5.) Install tile in compliance with Dade County Application Standard PA 120. (See "Data for Attachment Calculations" included in this Approval.) 1. For re -roof applications, " /3_" plywood is an acceptable substrate. Raul Rodriiuez Product Control No.: 95- 0316.04 SYSTEM LIMITATIONS 1: The standard minimum roof pitch for Lifetile's "CapriTM Tile ", low profile tile shall comply with Dade County Application Standards PA 118, PA 119 or PA 120, depending on the method of installation. 2. For nail -on applications, fasteners for mechanical attachment of tiles shall have a head diameter larger than that of the preformed holes in the tile. 3. System installation shall be in compliance with the system specifications outlined in this Product Control Approval. The method of attachment utilized shall provide sufficient attachment resistance expressed as a moment to meet or exceed the required moment of resistance determined in compliance with Dade County Protocol PA 115 or PA 127. The Lifetile "CapriTM Tile" tile profile has been tested for both wind characteristics and static uplift performance, therefore, attachment calculations for installation in compliance with PA 115 or PA 127 shall be done as a 'Moment Based System'. 4. For mortar or adhesive set tile applications, a field static uplift test by a Dade County accredited testing agency, in compliance with Dade County Protocol PA 106, shall be performed. 5. For mortar set tile applications, 30/90 hot mopped underlayment applications may be installed perpendicular to the roof pitch unless stated otherwise by the underlayment material manufacturer's published literature. 6 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo for identification in the field. 7. Applications for roofing permits shall include a completed Section ll of the Uniform Building Permit, a copy of Lifetile's current specifications and details, a copy of this Product Control Approval and a copy of the Product Control Approval of any Roofing Component used in the proposed tile application. Reference shall be made to appropriate data for the required fire rating. S. The applicant shall retain the services of a Dade County certified testing laboratory to maintain quality control in compliance with the South Florida Building Code and related protocols. Samples taken shall be in compliance with Dade County Protocol PA 112, Appendix 'A'. 9. Any amendments to these provisions shall be in compliance with Sections 203 and 204 of the South Florida Building Code. 13 ,74i/2 Raul Rodri?uez .1 Product Control No.: 95- 0316.04 DATA FOR ATTACHMENT CALCULATIONS Table 2: Restoring Moments due to Gravity - Mg (ft-lbf) from PA 102 Testing Tile Profile Table 1: Aerodynamic Multipliers - X (ft3) 4 ":12" 5 ":12" from PA 108 Testing 7 ":12" or greater Tile Direct Deck X (ft3) A. (ft3) Battens Profile Battens Batten Application Direct Deck Application Cape Tile Capri" Tile 5.92 0.27 0.29 Table 2: Restoring Moments due to Gravity - Mg (ft-lbf) from PA 102 Testing Tile Profile 3":12"* 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Capri" Tile 5.92 6.80 5.82 6.69 5.70 6.55 5.56 6.39 5.41 N/A Table 3: Attachment Resistance Expressed as a Moment - M, (ft-lbf) from PA 102 and PA 102(A) Testing' Tile Profile Tile . Application Approved Nails Approved Screws2 Approved - Field Clip With: Approved Eave Clip With: 1 nail 2 nails 1 screw 2 screws 1 nail 2 nails 1 nail 2 nails Capri" Tile Battens 4.10 7.10 22.90 49.10 24.20 34.80 22.10 32.20 Direct Deck 11.80 21.90 25.80 47.10 24.30 35.50 19.00 31.90 Data noted in Table 3 is for installation with a 3" tile headlap. 2 Approved screws are as noted in the 'Trade Names of Products Manufactured By Others' and 'Profile Drawings' sections of this Approval. Clips on eave tile are not required for this attachment configuration unless the Required Moment of Resistance exceeds the values noted above. 14 Raul Rodriguez Product Control No.: 95- 0316.04 DATA FOR ATTACHMENT CALCULATIONS (CONTINUED) Table 3 -A: Attachment Resistance Expressed as a Moment - Mt (ft-lbf) from PA 102 Testing Tile Profile Tile Application Two (2) 10d x 3" long nails' Capri- Tile Direct Deck New Construction (min. 19/32" plywood) 67.50 Direct Deck Recover/Reroof (min. 15/32" plywood) 43.00 Battens New Construction 50.90 Tile installation with a 4" headlap using two (2) Approved 10d x 3" long polymer coated, corrosion resistant, ring shank nails installed in manufactured holes located 2W from the head of the tile. Clips on eave tile are not required for this attachment configuration unless the Required Moment of Resistance exceeds the values noted above. Raul Rodriguez _ Table 4: Attachment Resistance Expressed as a Moment - M1 (ft-lbf) from PA 101 Testing Tile Profile Tile Application Attachment Resistance Capri'" Tile Mortar Set 20.60 Adhesive Set 86.61 Raul Rodriguez _ Product Control No.: 95- 0316.04 PROFILE DRAWINGS CArttuT" TILE 16 Raul Rod uez Product Control No.: 95-0316.04 PROFILE DRAWINGS • (CONTINUED) APPROVED SCREW FOR SCREW DATA IN TABLE 3 17 1174)/21- Raul Rodriauez METRO DADE METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE DEPARTMENT SUITE 1603 METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI. FLORIDA 33130.1583 NO ICE OF ACCEPTANCE: STANDARD CONDITIONS (305) 375 -2901 FAX (305) 375-2908 1. Extensions of Acceptance may be considered after a new application has been filed and the supporting data, test reports no older than ten (10) years, have been re- evaluated. All reports of re- testing shall bear the seal, signature and date of an engineer registered in the State of Florida. 2. Any revision or change in the materials, use, or manufacture of the product or process shall automatically be cause for termination, unless prior approval is granted for revisions or change. 3. Any unsatisfactory performance of this product or process or a change in Code provisions shall be grounds for re- evaluation. 4. This acceptance shall not be used as an endorsement of any product for sales or advertising purposes. 5. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 6. Product approval drawings, where required for permit applications, shall be provided to the applicant by the manufacturer or his distributors unless otherwise noted in the Notice of Acceptance. The prints need not be re- scaled by an engineer. 7. Failure to comply with the Standard Conditions shall be cause for termination of the Approval. This approval supersedes all previous approvals. 18 aul Rodriguez Product Control Supervisor lob Address: Contractor: APPENDIX 'E' METRO -DADE UNIFORM BUILDING PERMIT SECTION II MORTAR OR ADHESIVE SET TILE SYSTEMS 1. General The information provided in this Section is required to confirm Product Control Approval of the proposed tile system assembly; confirm compliance with the wind load requirements of Chapter 23 of the South Florida Building Code (SFBC); and confirm compliance with Sections 3403.5 and 3404 of the South Florida Building Code. 2. Documentation The following documents are required for submission with the Uniform Building Permit application: ► Two (2) copies of the proposed tile system assembly's and associated roofing component's Product Control Approval(s). ► One (1) copy of the tile system assembly and/or roofing component(s) manufacturer's published application instructions and literature. ► All documents attached herein, filled out and completed in full. 3. Project Information Check one of the following: • ❑sew Construction ® Re -Roof Note: Mortar or adhesive set tile systems are not acceptable as recover applications. Process No. Is the deck solid _ ed? (circle 'yes' or 'no') yes _ no Deck Tyne (check one of the following): l Nominal W' Plywood (for re -roof only) ❑ Nominal' /" Plywood ❑ Wood Plank " ❑ Other (fill in) Roof Pitch (fill in): " : 12" Note: Mortar or adhesive set tile systems shall not be installed at a pitch greater than 7W':12 ". Mortar or adhesive set tile applied at a pitch greater than 5 ":12" and less than or equal to 7 ":12" shall have the first three courses of tile nailed with not less than one nail per tile. As an alternate, the first three courses of tile may be applied in mortar over a single layer of minimum 12 ga. wire mesh with square openings of not less than '4" which is mechanically attached to the sheathing with not less than one nail per 2 ft'. Circle'ves' or 'no' for each of the following: Have you attached two copies of the tile system manufacturer's Product Control p _Laval for the proposed tile system? yes no Have you attached a copy of the tile system assembly and/or roofing component(s) manufacturer's published, application instructions an d tber literature no Is the proposed underlayment approved for use with this tile system assembly no Mortar or Adhesive Set Tile Systems Page -1 Job Address: Contractor: Proiect Information (continuedi: If the proposed underlayment is self - adhered, have you complied with the venting requirements of Section 2913.3 (b), (c) and (d) of the South Florida Building Code? yes no Are all related accessories approved for use with this tile system assembly? yes no Are the proposed edge metal attachment fasteners in compliance with the requirements of the South Florida Building Code (minimum 12 ga. annular rlrg, shank, corrossion reisistant nails)? 7 yes) no 4. The Tile System Assembly: The following information is required to confirm compliance with Subsections 3403.5(a) and (c) and Section 3404 of the South Florida Building Code. Tile: Tile Name: Manufacturer: \1- Tile Material: O ay Concrete O Other: Product Control Approval Number. 42‘1i--`� ° Z� Mortar or Adhesive: Process No. Mortar: Manufacturer: - vo.:= Mixing Ratio: O Adhesive: Type: Manufacturer: Tile Fasteners (for first three courses if roof pitch exceeds 5 " :12" and is less than or equal to 7 ":12 1: Check one of the following which apply to the proposed tile fasteners (for the first three courses) for use with the proposed tile system assembly: O Minimum 12 ga. galvanized roofing nail: Length: O Other: Type: Length: " " Note: All tiles Shall be installed in compliance with the provisions set forth in the tile system assembly manufacturer's Product Control Approval and the minimum requirements set forth in Subsections 3403.5(c) and 3404.2 of the South Florida Building Code. Tile fasteners in the first three courses (if applicible) shall be of sufficient length to penetrate the sheathing a minimum of 1" or through the sheathing thickness a minimum of '46", whichever is less. Underlayment: The following information is required to confirm compliance with Section 3403.5(b) of the South Florida Building Code. Check one of the following which apply to the proposed tile securement for use with the proposed tile system assembly: Mortar or Adhesive Set Tile Systems Page -2 Job Address: Contractor: Process No. Underlayment (continued): Spacing (ner tile system assembly Product Control Approval): Check all of the following which apply to the proposed underlayment for use with the proposed tile system assembly: Field: L " o.c. �,/ Laps: ��" o.c. U ASTM 830 ap t,saprated felt with: ❑ 19" overlap -ce �A / c . *5 ❑ 6" overlap 5. Related Accessories: 4" overlap Manufacturer: 0 ASTM #15 asphalt saturated felt with: Manufacturer: O 19" overlap O 6" overlap O 4" overlap eral Surfaced Roll Roofing with: t>i„TT, •y. - (k Manufacturer: 0 Other: Type: Manufacturer: O 19" overlap O 6" .verlap 4" overlap Edge Metal (refer to Section 3408.2 of the South Florida Building Codel: Type: Dimensions: Gauge or Thickness: Finish: w1' Note: All edge metal shall be nailed on the flange and nailed or clipped at the face in compliance with the provisions set forth in Dade County Protocol PA 111, marked Appendix 'U' in the South Florida Building Code. Underlavment Fasteners (if applicablel: Check one of the following which apply to the proposed underlaym9nt attachment: I!( Minimum 12 ga. electro- galvanized roofing nail with minimum 32 ga. x 134" tin cap: �� ( - � �,�; ► Length: 4v, 1� Manufacturer: t4-,* 0 Other: Type: Length: Manufacturer: " Adhesives (check one of the following): 0 Cold Adhesive: Mortar or Adhesive Set Tile Systems Page -3 Type: Manufacturer: Flashing Cement: Type: Manufacturer: (�. ' C. Job Address: Contractor: Adhesives (continued): Note: Application of adhesives shall be in compliance with the Roofing Component Product Control Approval and the minimum requirements set forth in Subsection 3403.5(e)(4)(cc) of the South Florida Building Code. Ventilation System (check one or more of the followinal: The following information is required to confirm compliance with Subsection 3401.4(e) of the South Florida Building Code. 0 Ridge: Type Size in= Be/Soffit: Type Size S in' Note: If underlayment is comprised of a self - adhered membrane, both soffit and ridge ventilation systems are required, unless a base sheet is applied as an anchor sheet below the self - adhered underlayment. Note: The Tile System Assembly shall be installed in strict compliance with the application instructions enumerated in the Product Control Approval. A permit shall be issued for application of the specified Tile System Assembly only. Any change to the specified Tile System Assembly shall require submission of a revised SECTION II with a copy of SECTION I, noting the permit number issued. Process No. Additional Notes: a,a;4� r op_:. \ ,-• =,z - cm- C-�� a 41 • &.t ' it ''t 2 iz`�r Mortar or Adhesive Set Tile Systems Page -4 } Job Address: Contractor: Process No. Deck: Opt: Underlayment: 6/ Underlayment Fastener: i gyp. \,` — "kes FILL IN APPLICABLE ROOFING COMPONENTS WIIICII MAKE UP TILE SYSTEM ASSEMBLY. INSERT ANY ADDITIONAL LEADERS INDICATING ADDITIONAL ROOFING COMPONENTS NOT SHOWN ON THIS PAGE. ( Where Roofing Component not used in Tile System Assembly, fill in with "N/A". ) Head Lap Dimension: ---21 (min:anrm 2'mdess Wm.*** spotted in the Ule system osstmblyProduet Control Mortar/Adhesive Tile: Tile Fastener. \c &T Ridge Venting: fUaPPlicabkJ al or utter FasteneEdge r Met ! \G� u �1 S Bird Stop:. f CI- yA U��•J l tr Edge Metal or Gutter. —1-- vkV ■t -%0 Existing or Proposed . Soffit Venting: DETAIL #1 Job Site Identification: Mortar or Adhesive Set Tile Systems Page - 5 Job Address: Contractor: Process No. Ridge Height Eave Height Roof Mean Height feet feet `1� feet Insert Building Ridge Height, Eave Height and Roof Mean Height. Also insert applicable information pertaining to the building below. ( See ASCE 748 Fact Sheet Attached) Exposure Category: C., Classification Category: At Hurricane° Occanlinc ?: Y 'N Basic Wind Speed at Building Location: 110 mnh Building Condition based on % of openings: (See Table 9 ofASCE 7-88) Ground Level BUILDING INFORMATION #1 Job Site Identification: Mortar or Adhesive Set Tile Systems Page - 6 Job Address: Contractor: Process No. 7_c Sketch Roof Plan, indicating all dimensions, slopes and any roof top equipment. Also insert variable labeled °a" which represents perimeter and corner dimensions per Chapter 23 of the South Florida Building Code. ( See ASCE 748 Fact Sheet Attached) BUILDING INFORMATION #2: Roof Plan with Perimeter and Corner Dimensions Job Site Identification: Mortar or Adhesive Set Tile Systems Page -7 Job Address: Contractor: The undersigned certifies that the Mortar or Adhesive Set Tile System Assembly is in compliance . with the plans, specifications, and details submitted by the architect. STATE OF FLORIDA - COUNTY OF DADE Before me this day personally appeared iA��'���� who, being first duly sworn, deposes and says that all information s emitted herein is true and correct Licensed Cont actor / Owner Signature Sworn to and subscribed before me this th day of 19 My commission expires: Notary Public State of Florida Mortar or Adhesive Set Tile Systems Page - 8 Process No. t9S 6/f4/1 Cji414 MARIA ISABEL SANTANA 2580 WEST 61 PLACE .' BLDG 1 APT. 102 , HiALEAH, F'l. 330i S a 0142 sr 31 ord4re cAr...TA 1`1N \' O 4`3 N "CAE Fl won National Bank N. a' a `up° asor Service l- 800 - 778 -1012 F 406 70064 3 21: L0 9000 6 70-241 BUILDING ❑ PLUMBING 0 PERMIT "= 38503 ROOFING , 2 .x'00060 L 2600.0 r.. MIAMI SHORES VILLAGE, FLORIDA Date Owner of I? Building L'' )L2%'2%� �.� 0 Architect Contractor or Builder Legal Description Address of Building /0 — r/ 1947: Contractor's License No. Work to be performed under this Permit 12,—"6-95' `/0/ 4/t /03 " YT14441-LAt.) -44-c Subdi- vision // 3/ Of O /3Q /L"% -- 194 c / ,. _�aZo . Sq. Ft. q (.(♦• 6. cc, Value of , I Amount of P r o j e c t $ I r m o • fl Permit $ I Z O? 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- don 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 4ahgwn o the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employe alt f/ 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 i fries/conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting jhis. -pe lime responsibility for all work done by either, myself, my agent, servant or employee. <� ' a-ri i. -i `l' - l26.0 0 CON : CTOR or BUILDER BY AUTHORITY PERMIIT- APPLICATION FOR MIAMI SHORES VILLAGE ° s Date ?- 7Job Address ? 0/ r /0 3 S} Tax Folio `• O 13° Legal Description LoT 13 LoT i Y r) j Aiker L e S I SIB Historically Designated: Yes No ?c, Owner/i essee / Tenant t4 • / iv°l N 1, e2 So hr J gC" /N • Master Permit # 3 32 Owner's Address Ofd I Ai E / es 354 in; *01, S/ o r 33/7r Phone 75—r — '71 '10 contractinia6Roageh Ooieveifit&' Qualifier w . /f �' is C_ Address i ►'v ,f ,� 422 SS# (�? / / Phone gry- 9 7y — 33d Competency # 0-66 &'/f 3 as--. Co. State # Municipal # Architect/Engineer Bonding Company Mortgagor Address 44:7— e 45fdc- rp Address (p 41/ 411 K + et. ✓J t-/ AT, 44. -;w PG 37/ ti Address Permit Type (circle one • BUILDING FCTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE WORK DESCRIPTION i icAluE ?cvst-)115 Square Ft 3/ op 11� SIGN Fcrimated Cost (value) 145-75'Z . c' 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 FLF,CTRICAL, 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. as to Owner and/or Condo President Date My Commission Expires: , - ''' Ennatee B. Conrad. MY COMMISSION # CC813392 EXPIRES datuiaty 14, 2001 WNW TORO TROY FAIN INSURANCE. INC. FEES: PERMIT APPROVED: Zoning Building �� �' i/L5197 Electrical Mechanical Plumbing Engineering RADON C.C.F. Signature of ' • ore . .• Date er -Btu 8 nrad Date My Commission E «j =r; MY COMMISSION # 13392 EXPIRES as to Contrac January 14, 2001 BONDED THRU TROY FAIN INSURANCE, INC. TOTAL DUE /4N60% METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING PRODUCT CONTROL NOTICE OF ACCEPTANCE All Broward Hurricane Panel Company 450 West McNab Road Ft. Lauderdale FL 33309 BUILDING CODE COMPLIANCE OFFICE SUITE 160 METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 PRODUCT CONTROL SECTION (305) 375 -2902 FAX (305) 372 -6339 Your application for Product Approval of: 20 ga Corrugated Galvanised Steel Storm Panel under Chapter 8 of the Metropolitan Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitte Applicant, along with Drawing No. 94 -98.1, sheets 1 and 2 of 2. (For listing, see Section 8 of this Notice of Acceptance) has been recommended for acceptance by the Building Code Compliance office to be used in Dade County, Florida under the specific conditions set forth on pages 2 et. seq. and the Standard Conditions on page 3. This approval shall not be valid after the expiration date stated below. The Office of Code Compliance reserves the right to secure this product or material at anytime from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The applicant shall re- evaluate this product or material should any ammendments to the South Florida Buildins Code be enacted affecting this product or material. The Building Code Compliance Office reserves the the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.:97- 0212.06 (Revises No.: 94- 1115.03) Expires:03 /14/98 Raul Rod 'guez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Metropolitan Dade County Building Code Compliance Department and approved by the Building Code Committee to be used in Dade County, Florida under the conditions set forth above. Approved: 03/13/97 s anger, Director Building Code Compliance De Metropolitan Dade County 9/-0212.06 1 \V.: APPROVED TO 1 3 1997 EXPIRES March 14. 1998 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS I. DESCRIPTION 1.1 This approves a galvanized 20 ga. steel storm panel designed to comply with the South Florida Building Code Impact Test Requirement and ASCE 7 -88 "Minimum Design Loads for Buildings and Other Structures ", for the following locations: 1.1.1 Non - coastal building zone. 1.1.2 Coastal building zone. 2. MATERIAL CHARACTERISTICS 9.1. The storm panels shall be constructed as indicated on approved drawing No. 94 -98.1, Sheet 1 of 2, using 20 ga. galvanized steel (0.035" thick), with Fy=40 ksi min., conforming to ASTM A446, structural quality grade C. 2.2 Panels (Part 1) are rolled formed, have a nominal width of 13.00" and a total width of 14.25 ", forming 1.87" deep ribs 2.3 Components shall be aluminum alloys 6063 -T6, (Part 2) "h" header, (Part 3) "u" header, (Part 4) 2" x 2" x .125 "EAB" studded angle, (Part 5) 5" x 2" x 1/8" angle. 2.4 Tested specimen: Dimensions: 37 1/4" wide x 101" long overall. (3 specimens) 3. LIMITATIONS 3.1 The design will be dependent on the maximum panel (span) height: 101" to be installed only as outlined on drawing No. 94 -98.1, Sheets 1 and 2 of 2. 3.2 Minimum separation to existing glass to protect shall be: 3 1/8 ". 3.3 Maximum clearance between top of panel and inside of header shall be 1/4 ". J.4 Special Requirement: All panels shall be fastened, using 1/4 " -20 x 1" sidewalk bolt and wingnut, at all overlaps at 1/3 span points. Panel spans smaller than 48" may be fastened only at midspan: 4. INSTALLATION 4.1 The panels shall be installed only in the following condition: 4.1.1 aI— l— (Direct Mount) The panels are secured at the head and sill, either directly to 1/2" x 7/8" Rawl Calk -In anchors embeded in the wall, spaced at 6 1/2" o.c., using 1/4 " -20 bolts and Key Hole Washers (Part 6) (Direct Mount); OR at the head to an "h" header (Part 2) anchored to the wall, using the tension anchors; and at the sill, to a continuous 2" x 2" x .125" studded aluminum "EAB" angle (Part 4), using 1/4 " -20 x 5/8" studs w /washered wingnut spaced at 6.5" o.c., which is anchored to the wall, using the tension anchors shown on detailed Drawing No. 94 -98.1, Sheet 2 of 2, Sections A "Wall Mount" and D "Direct Mount ", bearing the Dade County Product Control approval stamp. Ma uel Perez, P.E. Plans Examiner II Product Control Division -.Li 1:11, L L1 �...�.: `j / -u. 1 !AA) APPROVED : . L3. 1991_ EXPIRES March 14 1998 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 4.1.2 Buildout Mount The panels are fastened to the 2" x 2" x .125" continuous studded aluminum angle (Part "EAB ") at the head, using 1/4 " -20 studs whvashered wingnut spaced at 6.5" o.c., this angle is secured with 1/4 " -20 machine bolts & nuts @ 6" o.c. to the long leg of a 2" x 5" x 1/8" aluminum angle used to provide the buildout, this condition is repeated at the sill. The 2" x 5" x 1/8" angles are then anchored to the wall as shown on Drawing No. 94 -98.1, Sheet 2 of 2, Section C "Build -Out Mount ", bearing the Dade County Product Control approval stamp. 4.1.3 Ceiling/Inside Mount The panels are secured inside a top track ( "U" header) at the head, which is anchored to the inside of the opening; and fastened to the 2" x 2" x .250" continuous "EAB" studded aluminum angle at the sill, using 1/4 " -20 machine bolt and washered wingnut spaced at 6.5" o.c. as shown on Drawing No. 94 -98.1, Sheet 2 of 2, Section B "Ceiling/Inside Mount" bearing the Dade County Product Control approval stamp. 4.1.4 Any combination of the above. 4.2 Anchorage of the aluminum angles shall be to concrete, masonry and/or wood framing and shall consist of only the anchors, embedment and spacing specified on Drawing No. 94 -98.1, Sheets 1 and 2 of 2. Substitution of anchor type or indicated embedment is unacceptable and requires to be engineered separately. Fasteners must have their own Notice of Acceptance. 4.3 Permanent set fastener components, embedded anchor bolts, threaded cones or metal shields, not in use, must be protected against corrosion, contamination and damage at all time. 5. IDENTIFICATION 5.1 Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Dade County Product Control Approved ". 5.2 Also a Warning Note shall be permanently tamped in each panel advising the home owner or tenant that the storm panels will not offer hurricane protection unless all reinforcing bolts are properly installed. 6. USE 6.1 Application for building permit shall be accompanied by two copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Completely dimensioned drawing showing size and location, including height above grade, of openings to receive shutters; mean roof height, length and width of building. 6.1.3 Duplicate prints of approved drawings No. 94 -98.1, Sheets 1 and 2 of 2, bearing the approval stamp, Notice of Acceptance number and date by Dade County Product Control Section, clearly marked to show the components selected for the proposed installation. 6.2 The Building Official shall ensure the adequacy of shutter to meet the pressure requirement of the opening in which it is to be installed. 6.3 This approval renews Notice of Acceptance No. 94- 1115.03 dated March 30, 1995. -2a- Ma uel Perez, P.E. Plans Examiner II Product Control Division x'. 1 A. :1.4 APPROVED EXPIRES • /- U212.06 1 3 1997 March 14. 1998 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 7. TESTS PERFORMED TESTS: RESULTS: TEST • LARGE MISSILE IMPACT TEST SFBC PA 201 -94 TEST LOAD DESIGN LOAD Deflection CYCLIC WIND PRESSURE TEST SFBC PA 203 -94 POSITIVE CYCLIC WIND PRESSURE TEST SFBC PA 203 -94 NEGATIVE SATISFACTORY SI013A Max.. 3.10" +93.6 PSF S1013A & S1013B +72.0 PSF S1013A & S1013B UNIFORM STATIC AIR PRESSURE TEST SFBC PA 202-94 POSITIVE UNIFORM STATIC AIR PRESSURE TEST SFBC PA 202 -94 NEGATIVE DESIGN PRESSURE RATING -93.6 PSF SI013A &SI013B -72.0 PSF S1013A &S1013B +92.3 PSF S1013 +61.5 PSF S1013 @ Design 0.79" -92.3 PSF S1013 -61.5 PSF . S1013 +61.5 PSF -61.5 PSF 8. EVIDENCE SUBMITTED 8.1 Tests: 8.1.1 Test report on Large Missile Impact Test, Cyclic Wind Pressure Test and Uniform Static Air Pressure Test of 20 ga. steel storm panels, prepared by Construction Research Laboratory, Inc., Report No.S1013 dated June 30, 1994, signed and sealed by Vipin Tolat, P.E. 8.1.2 Test report on Large Missile Impact Test, Cyclic Wind Pressure Test of 20 ga. steel storm panels, prepared by Construction Research Laboratory, Inc., Reports No.S I013A dated June 30, 1994 and No. S 1013B dated October 14, 1994, both signed and sealed by Vipin Tolat, P.E. 8.2 Drawing: 8.2.1 Drawing No. 94 -98.1, All Broward Hurricane Panel Co., 20 gage, steel storm panels, Sheets 1 and 2 of 2, prepared by Knezevich & Associates, Inc., dated 06/16/94, with revision No. 8 dated 01/17/95, signed and sealed by V.J. Knezevich, P.E. 8.3 Material certification: 8.3.1 Mill Certified Inspection Report: Pending Submittal. 8.3.2 Certified Tensile Test Report from ATEC Associates, Inc., Reports #70- 02- 139044 dated June 24, 1994 and #70 -02- 140848 dated September 28, 1994, for 20 ga. steel, tested per ASTIvI E8 -92, signed and sealed by Peter G. Read, P.E. 8.4 Calculations: 8.4.1 Anchor analysis dated 1/12/95, Page 1 & 2, prepared by Kneze and Associates Inc., signed and sealed by V.J. Knezevich, P.E. -2b- Ma uel Perez, P.E. Plans Examiner II Product Control Division rtANC E iNO.: 97- 0212.06 APPROVED : 1 3 }99 . EXPIRES : March 14. 1998 NOTICE OF CCEPT4,yCF• STANDARD CONDITION l: Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and the original submitted documents, including test supporting data, engineering documents, are no older than eight (3) years. 2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, following statement: "Dade County Product Control Approval ", or as specifically stated in the specific conditions of this Acceptance. 3. Renewals of Acceptance will not be considered if: a) There has been a change in the South Florida Building Code affecting the evaluation of this product and the product is not in compliance with the code changes; b) The product is no longer the same product (identical) as the one originally approved; c) If the Acceptance holder has not complied with all the requirements of this acceptance, including the correct installation of the product; d) The engineer who originally prepared, signed and sealed the required documentation initially submitted, is no longer practicing the engineering profession. 4. Any revision or change in the materials, use, and/or manufacture of the product or process shall automatically be cause for termination of this Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5. Any of the following shall also be grounds for removal of this Acceptance: • a) Unsatisfactory performance of this product or process; b) Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other purposes. 6. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by the expiration date may be displayed�in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be rovided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at all time. The copies need not be resealed by the engineer. 8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of Acceptance. 9. This Acceptance contains pages 1, 2, 2(a) through 2(b) and this last page 3. 10. Items 1 11 & 12 listed below only a plv toto ala7d products and doors Unless specifically indicated in the Acceptance (approval), this unit is approved as a single unit installation. For multiple installation of this unit, a separate Acceptance for mullions is required from the Product Control Section. 11. The spacing of fasteners at window sills shall be as tested. The spacing of fasteners in all other parts of the frame, shall be as tested, but in no case shall exceed 24" on center. The first fastener shall be located at a maximum of 6" from each corner and mullion or stile. Fastener shall fully penetrate the buck, which shall be the same size as the one tested with the unit. No wood or plastic shields or pins shall be used for anchoring. See section four (4) of this approval for sizes of fasteners used in testing. 12. • Hardware for all windows and doors shall conform to Security and Forced Entry Prevention, Chapter 36 of the South Florida Building Code. Man el Perez, P.E. Plans E. END OF THIS ACCEPTANCE Prod - Control Division - 3 - finer 11 • I, .TCA.NE PANELS :. ICANE PANEL Job: SAL { .. >. 3 • (954) 974;- RtH ROAD, t A 1 F' 10fffl4, FL .334611 • (581) 968 -3360 1N.1 8TH STREET, MIAMI, FL 33186 • I.(305) ;252 -1500 RIrO1V .ROAD, SUITE T, LARGO, FL 346411 • (813) 585 -0021 BR.orislanffnarevve PQN5L Cat 450 West McNab Road Fort Lauderdale, Florida 33309 -2113 • (305).974-3300 ertalacrizot PLOT PL&N for: NPRi►�iN(4 ge,CN41alf)e -- s���/,t„J Lr.ve:6'4kJ Address: 4/°/ N2 /0,3 S /14/ —i 5-A o reams 33/r3S7 /=o /io // - ?- 3/ — 0 /S'" — o /30 Legal: Ygl A/". /a3 '5* /r). / A Rog 1. k. e ?.. • Lop 13.1- e5S 3(.1. 24"- Ft L. c'7" / Lj N.O.C.- $2500+ (Tea/No) > f' S Assoc. Approval wired (Tes/No) 4,0 It to 7 29.!a'.jLt6 3o. Sy )04° 31, 36 )c >3 trrrER TYPE: ac a I`d <,z J' OF OPENINGS ABOVE GRADE: ,All less than /c(" MEAN ROOF HEIGHT: ,R,15-: DATE: COMMUNITY AFFAIRS AND CODE ENFORCEMENT DIVISIONS 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138-2382 TELEPHONE (305) 795 -2204 FAX (305) 756 -8972 *** PLEASE PRINT iFlI* - l TIME: 1 ` l51S- NAME OF PERSON RE¢]ESTING FILE: STC N t E 1,4 k) ) YOLd2 ADDRESS: 4 ©( IQ F (Q3 ST. ADDRESS OF FILE RECUESTED: SA- M INFORMATION REQUESTED: L-OC4T(O 1\. ®F S E.f 1 C T i\.) I UsIDERSTAND THAT ALL DOCUMENTS IN THIS FILE ARE PITY OF MIAMI S} ES VILLAC E AND THAT AD DDablE TS MAY BE IMMO BL 1HIS FILE. YOU MAY GET UP TO (4)OCMPLIMENTARY COPIES. ADDITIONAL PIES WILL BE FURNISHED AT 15 CENTS PER PAGE, NAP IM LUDING BLUEPRINTS. ACX7WLEDGED BY (Signature) : FILE RETURNED - DATE: TIME: RETURNED 10: •_, PERMIT AP'LICATION FOR MIAMI SHORES VILLA ,E Date S ):V Job Address)( 4 v/ Ne,e 3 St Tax Folio Leal Description Historically Designated: Yes No Owner/Lessee / Tenant( S 1 bt C ds l fi</ Master Permit # �r� Owner's Address 0 i /�' E (0 3 S -� . Phone Contracting Co d? I d 0 /'f /� Address 6\ (ct {'" u ve , Qualifier ti kmot" e S (/ SS# q(90 -3( - (&51Phone ')5 _ 32C -116'6 Municipal # Competency # Ins. Co. fU c!di 4'1 S t a k e # C C C 0 51'tf Architect/Engineer fording Company Mortgagor Address Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING CHANIC WORK DESCRIPTION Iet c p ' 'r Nse c l.� f.' 1 )1,/ 1A-r � P VING FENCE SIGN Q�v1+,P h Square Ft. Estimated Cost (value) P 1f (9 0 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 on and zoning. Furthermore, I authorize the above -named contractor to do APPROVED: Zoning Si all applicable laws regulating 3 vv Date _.3-00 Notary as • Con My Commission E NOTARY Electrical Budding fires• GLADYS J ' i MARY PUBLIC STATE OF FLORIDA COMMISSION NO. C103 Y COMMISSION EXP. t I BOND TOTAL DUE 05/24 /2000 07:58 305- 324 -7822 ANGELL ROOFING PAGE 01 APPENDIX "F" REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS As it pertains to this Appendix "F ", it is r'.:e responsibility of the roofing contractor to provide the owner with the required roofing permit, to provide the owner with this appendix and to explain to the owner the content of this form, The provisions of Chapter 34 of the South Florida Building Code (SFBC) govern all the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. 1. Aesthetics - Workmanship: The ■vorkntanShip provisions of Chapter 34 are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a ionTig Code, should be addressed as part of the agreement between the owner and the contractor. 5� 2. •enailiqg Wood Decks: When replacing roofing. the existing wood roof deck may have to be renailed in accordance withithe current provisions of Chapter 29 of the SFBC. The roof deck is usually concealed prior to removing the existing roof system) St 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units i.e. townhouses, condominiums. etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 5,e,,, 4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The SFBC provides the option of maintaining this appearance. SL 'S. Funding 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. Pending may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. 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 Chapter 23 of the SFBC, 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. S. The owner may contact the Miami -Dade County Consumer S information regarding the above. r O� crSlAcnt'sSignatt Dut 721 e 1 r lent Contractor's Si.. rc further AppendizemEn UNIFORM ROOFING PERMIT APPLICATION PROCESS No. Contractor's Nam A 46040bAddrew 1{D lo3 1317(Low Slope Application) 0 (Nail-On Tile) 0 (Mortar-Atthenive S VW $09! cATEGWrf 0 (Asphalt/Fiberglass Shingles) 0 ( Metal RoofsWood Shingles 84 Shakes) 0 (Other) I 0 New Roof Re-roofing . 0 Recovering 0 Repair 0 Maintenance Flat Roof Area (IN) PO Sloped Roof Area (R2) Total (ft2) a 00 Master Permit No. Explore category (per ASCE 7-88): Building Classification category (per ASCE 7-88 table 1): • • • RQQF WIGHT AND SYSTEM DETAILS 0 11 ity We!! dosotai,*4 pies 1%4. r( 9,(05ct. SrIT Komit, 109,Juat, r ROOF PLAN • IQ yr. V Deck type: K(0 T 15&st ‘14ett ATTACHMENT it (1 Fastener Type: T 4/4. t (z,). $PACINQ II II itt Field: I Perimeter: LO Conten DETAIL 1 & 2 Page-1 METRoacto METROPOLITAN DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE -- — • METRO=DADE`FLAMER'BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 PRODUCT CONTROL NOTICE OF ACCEPTANCE (305) 375 -2901 FAX (305) 375 -2908 Firestone Building Products Company 525 Congressional Boulevard Cannel, IN 46032 PRODUCT CONTROL DIVISION (305) 375 -2902 FAX (305) 372 -6339 Your application for Product Approval of: Firestone APP & SBS Modified Bitumen Roofing System under Chapter 8 of the Miami -Dade County Code governing the use of Alternate Materials and Types of Construction, and completely described in the plans, specifications and calculations as submitted by: Factory Mutual Research Corporation, Underwriters Laboratories, Inc., and Dynatech Engineering, Inc. has been recommended for acceptance by the Building Code Compliance Office to be used in Miami -Dade County, Florida under the specific conditions set forth on pages 2-45 and the standard conditions on page 46. This approval shall not be valid after the expiration date stated below. The Building Code Compliance Office reserves the right to secure this product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this product or material fails to perform in the approved manner, the Building Code Compliance Office may revoke, modify, or suspend the use of such product or material immediately. The Building Code Compliance Office reserves the right to revoke this approval, if it is determined by the Building Code Compliance Office that this product or material fails to meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. ACCEPTANCE NO.: 97- 1106.02 Renews: 96- 0315.01 EXPIRES: 02/03/01 - Raul Rodriguez Product Control Supervisor THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE COMMITTEE This application for Product Approval has been reviewed by the Miami -Dade County Building Cgdel Compliance Office and approved by the Building Code Committee to be used in Miami -Dad op ity, Florida un pr e conditions set forth above. APPROVED: 02/03/98 Internet mail address: postmaster @buildingcodeoniine.com Charles Danger, P.E. Director Building Code Compliance Dept. Miami -Dade County Homepage: tittpJ/www.buiidingcodeonline.com Firestone Building Products Acceptance No.: 97- 1106.02 PRODUCT CONTROL NOTICE OF ACCEPTANCE ROOFING SYSTEM APPROVAL Applicant: Firestone Building Products Company Acceptance Number: 97- 1106.02 525 Congressional Boulevard Approved: February 3, 1998 Carmel, IN 46032 __ Expires: February 3, 2001 Category: Membrane Roofing Systems Sub - Category: Built -up Roofing Type: Modified Bitumen Sub -Type: APP /SBS System Description Firestone Building Products Co., is a producer of asphaltic and synthetic roof membranes and insulation products marketed nationally. Firestone produces a wide range of roof products for build-up and modified bitumen rooting systems. The modified bitumen products include both APP and SBS products in smooth, granule, and fire rated versions. Firestone Building Products Co., products are distributed through a network of roofing wholesale distributors throughout the South Florida area. Firestone modified bitumen membranes have been tested in compliance with ASTM D 5147 and-with ASTM E 108 test requirements. Contact: Greg Brandt Manager, Codes Dept. Firestone Building Products Company 525 Congressional Boulevard Cannel, IN 46032 -5607 (317) 575 -7000 ext. 7199 Page 2 uloaga Roofing Product Control Examiner • Firestone Building Products Acceptance No.: 97- 1106.02 Insulation Types: Fibrous glass Perlite Fiberboard Rockwool Polyisocyanurate Expanded polystyrene (EPS) Polyisocyanurate Composite Board Extruded Polystyrene (XEPS) Maximum Design Pressures Material Wood Design Pressure -52.5 psf Page 3 ran Zuloaga Roofing Product Control Examiner Firestone Building Products Acceptance No.: 97- 1106.02 Product APP 180 APP 180 FR APP 170 APP 160 MB Base Sheet SBS SBS FR SBS Premium FR SBS Base Sheet SBS Smooth SBS Premium TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT Test Product Dimensions Specification Description 39.4" x 32'10" ASTM D 5147 Polyester reinforced modified bitumen, granule surfaced membrane. Torch applied. Polyester reinforced, fire regardant modified bitumen, granule surfaced membrane. Torch applied. Polyester reinforced modified bitumen membrane. Torch applied. Polyester reinforced modified bitumen membrane. Torch applied. Fiberglass reinforced base sheet, asphalt coated on both sides. Applied in hot asphalt or mechanically attached. Granule surfaced, modified bitumen membrane reinforced with non -woven polyester mat. Ceramic granule surface, modified bitumen membrane reinforced with non -woven polyester mat. Ceramic granule surface, fire rated, modified bitumen membrane reinforced with non -woven polyester mat. Fiberglass reinforced SBS base sheet. Applied in hot asphalt or mechanically attached. 39.4 "x32'10" ASTM D5147 39.4" x 33'6" 39.4" x 32'10" 36" x 108' ASTM D 5147 ASTM D 5147 ASTM D 5147 39.4" x 33'10" ASTM D 5147 39.4 "x33'10" 39.4" x 33'10" 39.4" x 50' 39.4" x 33'10" 39.4" x 33'10" ASTM D 5147 ASTM D 5147 ASTM D 5147 ASTM D 5147 Smooth surfaced, modified bitumen membrane reinforced with non -woven polyester mat. Applied in hot asphalt. ASTM D 5147 Granule surfaced, modified bitumen membrane reinforced with polyester mat. Applied in hot asphalt. Page 4 • uloaga Roofing Product Control Examiner • Firestone Building Products Acceptance No.: 97- 1106.02 Test Product Product Dimensions S Specification Description Manufacturer GAFGLAS # 75 3' x 108'; Roll ASTM D 4601 G2 Fiberglass base sheet GAF Materials weight: 75 Corporation lbs. (with current PCA) GAF Stratavent ASTM D 4601 Asphalt coated, granule GAF Materials surfaced, glass mat Corporation (with current PCA) GAFglas ASTM D 4601 Glass mat base sheet GAF Materials Corporation (with current PCA) #6192 -900 PA 121 Roof coating Gibson - Homans (with current PCA) Durakote #151 PA 121 Roof coating Gilsonite (with current PCA) Asphalt Primer ASTM D 41 Asphalt Primer generic Asphalt ASTM D 312 Type III or IV Hot asphalt generic bitumen adhesive High Density Wood various PA 110 Wood fiber insulation generic Fiberboard board Perlite Insulation various PA 110 Perlite insulation board generic Red Rosin various Rosin paper for barrier generic layer on wood decks Roofing Nails Minimum # PA 114 Corrosion resistant annular generic 12 ring shank nails , Tin Caps Min. 32 ga. x 15/5" discs. Base Sheet ASTM D 4601 G2 Base sheet generic Type it Corrosion resistant circular generic Page 8 Roofing Product Control Examiner Firestone Building Products Acceptance No.: 97- 1106.02 Test Product Dimensions Specification Olympic Fastener #14 Olympic Metal Plate Olympic CR Fastener CR Base Sheet Disc Olympic Strap Toggle Fiberglas Multi -Max FA GlasBase GlasKap various various Product Description PA 114 Insulation fastener PA 114 Metal plate for use with Olympic fasteners PA 114 Insulation fastener assembly for lightweight concrete PA 114 Galvalume disc for use with Olympic CR Fastener PA 114 Insulation fastener PA 110 Fiber glass roof insulation PA 110 Polyisocyanurate foam insulation 36" x 108' ASTM D 4601 Type II asphalt impregnated and coated glass fiber base sheet 36" x 36" ASTM D 3909 Asphalt impregnated and coated felt surfaced with mineral granules for use as top ply Page 10 Manufacturer Olympic Manufacturing (with current PCA) Olympic Manufacturing Group, Inc. (with current PCA) Olympic Manufacturing Group, Inc. (with current PCA) Olympic Manufacturing Group, Inc. (with current PCA) Olympic Manufacturing Group, Inc. (with current PCA) Schuller International (with current PCA) RMAX (with current PCA) Schuller International (with current PCA) Schuller International (with current PCA) uloaga Roofing Product Control Examiner Firestone Building Products Acceptance No.: 97- 1106.02 TEST REPORTS Test Agency Test Identifier Description Date Factory Mutual J.I. 1N6A6.AM Wind Uplift 01/10/89 Research Corporation Classification Factory Mutual J.I. 1Q3A2.AM Wind Uplift 10/08/90 Research Corporation Classification Factory Mutual J.I. IT8AI.AM Wind Uplift 07/30/91 Research Corporation Classification Factory Mutual J.I. 1T8A2.AM Wind Uplift 07/23/91 Research Corporation Classification Factory Mutual J.I. OW IA8.AM Wind Uplift 12/07/92 Research Corporation Classification Factory Mutual Research J.I.0Z5A3.AM Wind Uplift 03/08/95 Corporation Classification Factory Mutual Research J.I. 2Y3A3.AM Wind Uplift 11/28/94 Corporation Classification Factory Mutual Letter Approval Extension 12/03/92 Research Corporation Factory Mutual Letter Approval Extension 03/19/91 Research Corporation Factory Mutual Letter Name Change 06/15/90 Research Corporation South Florida FBPC -1 X- 1 185 ASTM G 26-90 09/10/92 Test Service Underwriters R9516/88NK22583 Fire Classification - 11/30/88 Laboratories Compliance Underwriters R9516/88NK28925 Fire Classification 03/29/89 Laboratories Compliance Page 13 Frank Zuloaga Roofing Product Control Examiner Firestone Building Products Acceptance No.: 97- 1106.02 Test Agency_ Test Identifier Description Date Underwriters R9516/89NK 18670 Fire Classification 04/02/90 Laboratories Compliance Underwriters R9899 Fire Classification 05/12/88 Laboratories Compliance Underwriters R9899/86NK8498 Fire Classification 08/14/86 Laboratories Compliance Underwriters R9899/87NK7630 Fire Classification 11/03/87 Laboratories Compliance Underwriters R9899/88NK7005 Fire Classification 03/29/88 Laboratories Compliance Underwriters R9899/81NK25749 Fire Classification 08/26/82 Laboratories Compliance Underwriters Letter Name Changes 02/08/90 Laboratories Underwriters R9516/94NK11625 Fire Classification 08/08/94 Laboratories Compliance Underwriters R9516/95NK2269 Fire Classification 02/03/95 Laboratories Compliance Trinity Engineering, Inc. 4810.01.96 -1 Uplift Resistance 01/31/96 PA 1 14(C) and PA 114(D) Exterior Research & 4810.10.96 -1 Uplift Resistance 10/31/96 Design, LLC. PA 114(J) Page 14 Zuloaga Roofing Product Control Examiner Firestone Building Products Acceptance No.: 97- 1106.02 Membrane Type: Deck Type 1: Deck Description: System Type E: APP Wood, Non - insulated 19 4=" or greater plywood or wood plank decks Base sheet mechanically fastened. All General and System Limitations apply. Base Sheet: Fastening: Ply Sheet: Membrane: Surfacing: Maximum Design Pressure: Maximum Fire Classification: Maximum Slope: One ply of Firestone MB Base Sheet, Celotex Vaporbar GB, Manville GlasBase or Perma Ply 28 mechanically fastened to the wood deck as described below: Anchor sheet shall be lapped 4" and fastened with approved roofing nails and tin caps 9" o.c. at the lap and two rows staggered in the center of the sheet 18" o.c. None. One ply of APP 160, APP 170, APP 180 or APP 180 FR torch applied parallel to the base ply, with overlaps staggered 12 ". Install one of the following: I. Gravel or slag at 400 Ib. and 300 lb., respectively, set in a flood coat of type III or IV asphalt at 60 lb./sq.. 2. Karnak No. 97, No. 97 AF or No. 169 at an application rate of 1 %, gal./sq.. 3. Fields F900 emulsion, Gilsonite Durakote # 151, Gibson Homans #6192 -900 applied at 6 gal./sq. with 60 lbs. of roofing granules set in the wet coating. 4. Owens Corning Fiberglass Cap sheet GAF Mineral Surface Capsheet or Manville Glaskap in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 Ibs.sq.. APP 180 FR does not require 1, 2, 3 or 4 above to achieve a UL Class A fire rating. -45 psf (See. General Limitation #13) See General Limitation #2. 2:12; see General Limitation #3. Page 38 rank Zuloaga Roofing Product Control Examiner "Firestone Building Products Acceptance No.: 97- 1106.02 Wood Deck System Limitations: 1. A red rosin sheet shall be installed on all wood plank decks to eliminate asphalt seepage and bonding of base sheet to wood plank deck. Red rosin sheet may also be installed on plywood decks as an option. 2. Pre - assembled 'Cap Nail' shall not be used for base sheet attachment. Page 43 Frank Zuloaga Roofing Product Control Examiner Firestone Building Products GENERAL LIMITATIONS 1 Asphalt moppings shall with applied with approved asphalt and shall be in compliance with equiviscous temperature ( VT) methods for asphalt applications. Asphalt containers or bulk tickets shall indicate an E , finished blowing temperature (FBT) and flash point. Asphalt types and temperature ranges s all be in compliance with the South Florida Building Code. 2 Fire classification is not of this acceptance. Fire classifications shall be in compliance with chapter 37 of the South lorida Building Code. Refer to a current Approved Roofing Materials Directory for fire ratings . f this product. 3 Maximum slope range ay vary for each system consult manufacturer's specifications and a current Approved Roofi g Materials Directory for compliance with design criteria for each application. 4 An overlay and/or recove board insulation panel is required on all applications over closed cell foam insulations when th base sheet is fully mopped. If no recovery board is used the base sheet may be applied using spo mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in th rows, one at each sidelap and one down the center of the sheet allowing a continuous : of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' n each ribbon to allow cross ventilation. Asphalt application of either system shall be at a mini um rate of 12 lbs.sq. Note: Spot attached systems shall be limited to a maximum design pr : are of-45 psf. 5 All work shall be perform d by licensed familiar with the details and specifications published by Acceptance No.: 97- 1106.02 Jthe manufacturer, and the quirements of the SFBC. 6 All attachment and sizing f perimeter nailers, metal profile, and/or flashing termination designs shall conform with Miami Dade County Roofing Application Standard PA 111 and the wind load requirements of Chapter 3 of the South Florida Building Code. 7 Perimeter and corner a shall comply with the enhanced uplift pressure of these areas,_as calculated in compliance ith Chapter 23 of the South Florida Building Code. Fastener densities shall be increase for both nsulation and base sheet as calculated in compliance with Miami -Dade County Roofing Applicat on Standard PA 117. (When this limitation is specifically referred within this NOA, Genera Limitation #13 will not be applicable.) 8 Fastener spacing for base heet attachment is based on a Minimum Characteristic Force (F) value as tested in compliance w th Miami -Dade County Protocol PA 105. If the fastener values as tested are below those list d in the System Limitations, a professional engineer may submit a revised fastener spacing ut Iizing the withdrawal resistance value taken from a Miami -Dade County Protocol PA 105 t st report and calculations that comply with the wind load requirements of Chapter 23 of the South Florida Building Code and Roofing Application Standard PA 117. 9 Fastener spacing for insul ion attachment is based on a Minimum Characteristic Force (F) value of 275 Ibf., as tested in co pliance with PA 105. If the fastener value, as field tested, are below 275 Ibf. insulation attachm nt shall not be acceptable. 10 Insulation may be installe in multiple layers. The first layer shall be attached in compliance with Product Control Approval uidelines. All other layers shall be adhered in a full mopping of approved asphalt applied ithin the EVT range and at a rate of 20-40 Ibsisq., or mechani attached using the fastening pattern of the top layer. -- 440 Page 44 Roofing Product Control Examiner CERTIFICATE OF OCCUPANCY ir MIAMI SHORES i GE, FLORIDA BUILDING IVISION Miami Shores illage, Florida, - — r <>Amer, Agent or Tencmtaof Building LotAg1451-141-(21311■., Street Address .4 0 t YL. Su visio Approved use by occupancy Remarks: X This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildiAgs or structures. /11 "T, w erow",efs # ve-t•AJL.,. 1 CERTIFIC4TE OCCUIDANCY HORES GE, FLORIDA UILDING DIVISION -7- BUILDE4q DIVISION N° 110 Owner, Agent or l'encmt of Buil Lot B1 Street Address 4 Approved use by occupancy Remarks. icmii Shores Village, Florida, :1- ( „ Subdivisio This' Certificate of Occupancy is [sued to the above named for building at abnve named lo . 'on only upon the express provision th the appliccmt will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, lrnoWn as the Zoning, Electrical, Plumbing and iBuilding Ordinances of Miami Shores 'Village pertaining to the erection, construction, alteratt n or remodeling of buildings or structures. - i -ie i ,.,:ki ` ,+ .'" ..a.` -.,..r.' 1 ' ,L li . . _ - - - --1.*Amo - WILDING IVISION Firestone Building Products 11 All standard panel sizes a asphalt, panel size shall be 12 Roll good materials shall b 13 The maximum designed pr (i.e. field, perimeters, and for enhanced fastening at e (When this limitation is s not be applicable.) Acceptance No.: 97- 1106.02 e acceptable for mechanical attachment. When applied in approved 1' x 4' maximum. stored on end and on a clean, flat and dry surface. ssure limitation listed shall be applicable to all roof pressure zones orners). Neither rational analysis, nor extrapolation shall be permitted hawed pressure zones (i.e. perimeters, extended corners and corners). cifically referred within this NOA, General Limitation #7 will Page 45 Frank Zuloaga Roofing Product Control Examiner MIAMISEPRES VILLAGE BUILDING DEPARTMENT 305;795-2204 Building IniPection Request Dater:i Type Insp'n (fir ,.4-11PkA -Ft.( 1/‘ Permit No. Name Address 44 • Company Phone # Inspection Date i0 Approved Lp Correction Re-Insp'n Fee ZA 3205 uplia MIAMI SHORES VILLAGE yr/ BUILDING DEPARTMENT 305-795-2204 Building Inspection Request Date011114 Type Insp' n tClId`ql—On Pr Permit No. C) \ 14-1 Name FN Address 40 Company Phone # Inspection Date —1 Mr CIS Approved Correction Re-Insp'n Fee . O... • Firestone Building Products Firestone Building Produc i Company 525 Congressional Boulevar Carmel, IN 46032 1 Acceptance No.: 97- 1106.02 ACCEPTANCE NO.: 97- 1106.02 APPROVED : February 3. 1998 EXPIRES : February 1 2001 NOTIC ; OF ACCEPTANCE STANDARD CONDITIONS Renewal of this Acceptance (< ppro.val) shall be considered after a renewal application has been filed and the original submitted documen ion, including test supporting data, engineering documents, are no older than eight (8) years. 2 Any and all approved produc shall be permanently labeled with the manufacturer's name, city, state, and the following statement "Miami ' - • e County Product Control Approved ", or as specifically stated In the specific conditions of this A ptance. 3 Renewals of Acceptance will of be considered if: a) There has been a change the South Florida Building Code affecting the evaluation of this product and the product is not in com liance with the code changes; b) The product is no longer a same product (identical) as the one originally approved; c) lithe Acceptance holder not complied with all the requirements of this acceptance, including the correct installation of the product; • d) The engineer who orig' lly prepared, signed and sealed the required documentation initially submitted, is no longer practicing th engineering profession. 4 Any revision or change in the aterials, use, and/or manufacture of the product or process shall automatically be cause for termination of th' Acceptance, unless prior written approval has been requested (through the filing of a revision application with appropriate fee) and granted by this office. 5 Any of the following shall a be grounds for removal of this Acceptance: a) Unsatisfactory perfo ance of this product or process; b) Misuse of this Accep ce as an endorsement of any product, for sales, advertising or any other purposes. 6 The Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance is displayed, then it shall be done in its entirety. 7 A copy of this Acceptance as ell as approved drawings and other documents, where it applies, shall be provided to the user by the m ufacturer or its distributors and shall be available for inspection at the job site at all times. The copies need of be resealed by the engineer. 8 Failure to comply with any s ion of this Acceptance shall be cause for termination and removal of Acceptance. 9 This Acceptance contains page 1 through 46. END OF THIS ACCEPTANCE Page 46 Frank Zuloaga Roofing Product Control Examiner I53 NOV 1 6 2005 MIAMI SHORES VILLAGE MIAMI SHORES VILLAGE BUILDING DEPARTMENT BUILDING DEPARTMENT 305 - 795 -2204 305- 795 -2204 Building Inspection Request Building Inspection Re . uest Dated 1 J Type Insp'n L Permit No. Name Address /� `�('� �✓ 1 Company t - Y CS Phone # Inspection Date Approved Correction Re- Insp'n Fee Date Type Insp / . Permit No Name .� a Address �— L Company Phone # For In tor: Name ate Ap oved )) Correction ❑ R - Insp'n Fee Protect Address Miami Shores VIIIage 10050 N.E. 2nd Avenge Miami Shores, FL 331 : 8 000 Phone: (305)795 -22 Parcel Number Expiration: 05/0912010 Applicant 401 103 Street Miami Shores, FL 33138 -2456 Owner Information 1122310150130 Block: Lot: SABRINA CLERGE Address SABRINA CLERGE 401 103 Street MIAMI SHORES FL 33138- Phone CeII Contractors) Phone CeII Phone CALEX ELECTRICAL CORP 305 - 271 -5164 Type of Work: Additional Info: Classification: Residential Valuation: Total Sq Feet: $ 600.00 0 Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $160.00 $3.00 $50.00 ($50.00 $0.80 $169.60 Invoice # Total Amt Paid Amt Due EL -11 -09 -36304 $ 169.60 $ 50.00 ; 13 EL -11-09 -36304 $ 169.60 $ 169.60 $ 0.00 For Inspections please call: (305)762.4949 Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the p ans, 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 November 12, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Colly November 12, 2009 1 p. II MIAMI SHORES VILLAGE, - FLA, N9 6429 INSPECTION TIME READY REMARKS. • /` /o -2-77_ INSPECTOR DATE 1°- 2 v ���,,o,� Miami Shores Village �lt° Building Department /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 it Type: Electrical wner's Name (Fee Simple Titleholder) .SA 3RlIVA CLE R h f Owner's Address iii ®1 1 J E Wet S- City h i Atli S i0f(s State F L Tenant/Lessee Name E -MAIL: s tbr;WA -8444 _ yahoo .Conn rot Job Address (where the work is being done) 4(11 N E. I Da S'f• of A11 % Shores City Miami Shores Vill . le County Miami -Dade Zip FOLIO /PARCEL# II - 2,231 -b15 013D Is B • • ding Historically Designated YES NO Contractor's Company Name C'�}LEX �t F_(`f�iC COd��. Phone # C 0 5 ,7 .2 '% 1,. n- j 6 i JCi?) a I� 4']I( Contractor's Address 1 O )g O 5 ys! G a* S rR Err Permit No. 6L -1) °r18 2 / Master Permit No. Phone# qli- n7- 5yi4 Zip 33138' Phone # Fi 3313K 3313$' City H i Art *I Qualifier Name awif PRrei -� State F L Zip 33173 Phone # 7 r6 2 I 0 .'( 7 i1 State Certificate or Registration No. EC - 0003/0e Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # //1 / Value of Work For this Permit $ 0 Q • Square / Linear Footage Of Work: T pe of Work: DAddition ❑Alteration ❑New Repair/Replace ❑ Demolition Describe Work: I &K*dtA f X #! T /*A" 2 AT rtsCA/ S u1 Awl �8�4 d s /A i NP4, t A'P Iv/ geed Ktr.S J /GO 4a1f1. \I 1 �t * ** *,�* * ** ** * * *** **** *,r,r,r,�,�a*** * * ** Fees*** * **** * * *** ***** ***** r * ** * *,�,�*** *,�,t*** ** Submittal Fee $ 5-0. CI ° Permit Fee $ /6". p, CCF $ , C90 CO /CC '''''''..- Notary $5 Jab Training/Education Fee $ . � Technology Fee $ • O[7 Scanning $ 3.004 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ I(t (,o See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 broc j 1 be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commee must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In e of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this a The foregoing ' i +` "ent was acknowledged before me thig d a y of O • , 20 p y, by $ rj in a. Glees ` , day of 1\J ) , 20dR who is personally known to me or who has produced — who is personally known As identificatio ells; did take an oath. Y / `1 ( 0 NO ' Y PUB o..` ° :tiO,,t� F SO :"', Sign: Print: IC: My Commission Expires: 0110212010 1 1 ;, n Print: '2'e�iittir t c§1% My Commission Expires: pia � by 0/47W5 rlit°2 who has produced A..14. NOTARY PUB Sign: and who did take an oath. APPLICATION APPROVED B (Revised 02/08/06) Plans Examiner Engineer Zoning Permit No: 09- Job Name: % fren' f d./Fn p eRe , 2009 Miami Shores Vivage Building Department ELECTRIC Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 -arty /Zza c e- -5 Ii` /1e/c d -it.13er,i ke.t/e /, 1. �' s 1,-/5e-, 1' Gc �� %z`��%T-�� ✓� �i� e g e ''i> v' ., 57e/es 'ce /`- J) L 9 ��/�® / 5 -% e A-7/i c--fr/V, 400140Pr'-- Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Mike Devaney 305 - 795 -2204 f r... .....,...f.. 1 dwva $ it afl • LOAN # 3013381748 SPECIAL WARRANTY DEED Made this 9th day of October, 2009, by JPMORGAN CHASE BANK, NATIONAL ASSOCIATION a Corporation existing under the laws of the State of NY whose address is: 2424 NORTH FEDERAL HIGHWAY, SUITE 360, BOCA RATON, FL 33431 hereinafter called Grantor, and to: SABRINA CLERGE and whose mating address is: , , FL, hereinafter called the Grantee. Grantor, in consideration of TEN DOLLARS ($1 0.00) AND OTHER GOOD AND VALUABLE CONSIDERATION paid by Grantee, grants and conveys to Grantee that property located in the County of MIAMI DADE, State of Florida, described more particularly as follows: Lot 13, Tess the North 34.25 feet and all of Lot 14, of MIRROR LAKE SUBDIVISION, according to the Plat thereof on fie in the Office of the Clerk of the Circuit Court, in and for Miami -Dade County, Florida, as recorded in Plat Book 56, Page 15. PARCEL ID 8: 11. 2231 -015-0130 AKA: 401 NORTHEAST 103 STREET, MIAMI SHORES, FL 33138 Subject to easements and restrictions of record. Subject to the lien of the General Taxes for the year 2009 and thereafter. Grantor covenants as follows: 1. That the premises are free from ail encumbrances made by Grantor, and 2. That Grantor will warrant and defend the property hereby conveyed against the lawful claims and demands of all persons claiming by, through, or under him, but against none other. IN WITNESS WHEREOF, the said party of the first part has caused these presents to be signed in its name by its proper officers, and its corporate seal to be affixed, attested by its secretary, the day and year above written. Signed, Sealed and aetivered JPMORGAN CHASE BANK, NATIONAL In the Presence of: ASSOCIATION 6 Kandie George Printed N NICK1 DR1GGERS Printed Name: STATE OF: By: JPMORGAN CHASE, 2424 NORTH FEDERAL HIGHWAY SUITE 360 BOLA TON, L 33439 . Printed Name: Brenda Oxford Title: Vice President COUNTY OF: • I HEREBY CERTIFY that on this date �( ,/day of . c , 2009, before me personally appeared Benda Oxford (Primed Name), ice Prey' (Title) JPMORGAN CHASE„ of JPMORGAN CHASE BANK, NATIONAL ASSOCIATION, a corporafor�'tirfder the laws of the State of NY, to me personally known and who signed the foregoing instrument as such officers for the uses and purposes therein mentioned and that they affixed thereto the official seal of said corporation, an that the said insgument is the act and deed of said - W f l'IVF�S^� my signature and official seal on _ day of /� �J_yl '.2009 In the County of NOTARY C (signature) Print Name: My Commission more1ff Wig Stamp/Seal: Prepared by Michele Rosa Sunbelt Title Agency 26750 U.S. Hwy 19 North Suite 400 Clearwater, FL 33761 and the State MIAMI SHORES VILLAGE Building Department 10050 NE 2 Ave, Miami Shores Fl, 33138 Tel: 305 - 795 -2204• Fax: 305 -756 -8972 Permit No. REOC- 9-09 -1522 Certificate of Re- Occupancy Address: 401 NE 103 Street City: Miami Shores Village State: Florida Zip: 33138 This certificate verifies that the reference property has been inspected by Miami Shores 'Village and has been determined to presently comply with schedule of regulations of. Miami Shores Land and Development Code pertaining solely to the requirement that each one - family dwelling is used and intended to be used for a one family dwelling purpose only however, this certificate does not constitute any representation or warranty as to the condition of the dwelling or other structures on the premises described herein, or any aspect of such condition, and interested persons are advised and encouraged to make their own inspections of the premises in order to determine the condition thereof. Building Officials Approval: gan.i1,o, CBo e-e 11-1 RU =LIN= TEC.HNOLOGI L'S PHONE: 866 -772 -0813 ; INFO @TRUELI:ETECH.COM FAX: '56S-772-H15 WWW.TFUEUNETECH.COM Page 1 of 2 in order 17841 File number. 7938091764 Client: SUNBELT TITLE AGENCY Lender. CHASE HOME FINANCE Buyer: SABRINA CLERGE Seller: JPMORGAN CHASE BANK, NATIONAL ASSOCIATION Completed: 10/2/2009 Surveyed: 10/1/2009 COMMUNITY NUMBER: 12086 PANEL: 0302 SUFFIX: L INDEX DATE: F.I.R.M DATE: 09/11/2009 ZONE: X Premises: 401 NORTHEAST 103 STREET , MIAMI SHORES, FLORIDA Description of encroachments, violations or other points of interest at the time of the inspection: NONE VISIBLE CERTIFIED TO: LEGAL DESCRIPTION: SUNBELT TITLE AGENCY, CHASE HOME FINANCE, SABRINA CLERGE, FIDELITY NATIONAL TITLE INSURANCE COMPANY LOT 13, LESS THE NORTH 34.25 FEET AND ALL OF LOT 14, OF MIRROR LAKE SUBDIVISION, ACCORDING TO THE PLAT THEREOF ON FILE IN THE OFFICE OF THE CLERK OF THE CIRCUIT COURT, IN AND FOR MIAMI -DADE COUNTY, FLORIDA, AS RECORDED IN PLAT BOOK 56, PAGE 15. (12Y.920/212009t ...:er_:: s.^ n•.- y, �: tr1a; mtx- =•- :r,.:'&:'= .q�:,•..,.: -:. a"_,�:x:w .aa .r,,.�xs;•.. THE FLORIDA LICENSED LAND SURVEYOR WHOSE SEAL APPEARS ON THE FACE OF THE SURVEY CERTIFIES THAT THE SKETCH CONTAINED HEREIN IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY MADE UNDER THEIR DIRECTION AND THAT SAID SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYS, PURSUANT TO SECTION 472.027, FLORIDA STATUTES, AND CHAPTER 61G-17-6 FLORIDA ADMINISTRATIVE CODE. FURTHER THE DOCUMENT IS ELECTRONICALLY SIGNED AND SEALED PURSUANT TO SECTION 472.027 OF THE FLORIDA STATUTES AND CHAPTER 61G-17- 7.0025 OF THE FLORIDA ADMINISTRATIVE CODE. TTEECCHNOLOGI S LLC PROVIDES THE DIGITAL TRANSMISSION NSMISSIOON AND BEEN OP THE PRODUCT MID S NOT INVOLVED INS ��F� OF THTECHNICAL ' FIELD WPERFORMED RK MAKES (Boundary Survey Ireland & Associates Surveying, Inc. 5725 Wayside Drive Suite 1002, Sanford, FL 32771 Office - 407.678.3366 Fax - 407.320.8165 Page 2 of 2 2 I LuEz- Z- Fn: (No Could Not Access Lot 12 I∎W' Q S 89°58'30° E(P) 110.00r(P) Frei. W Iran Pipe I (No Identification) of Lot 13 Fnd. vs° Imo Pipe Not Included (No Identification) S 89 °58'30° E(D) 113.17'(D) S 89 °58'30° E(M),107.04'(M) 4. �qt 418 WAIT 34.48'(Pj t j i 0 w W M 0 z 2 Z W Idenlf� ) su Screened Lot 14 `oa,aru- NC � Sys A Portion of Lot 13 7843'(P) 75.00'(P) E(M) Edge of Water COilatet0 EIock Well Witness Monienent Fnd. Nall (No Ideron) U1 In O O o to m N O m = 21J w , • o co 2s m Fntl 'fi Iron Pipe a (No tdet on) C-1 (P&M) Radius = 25.00' Delta = 89° 38'40° .Length = 39.11' S 89 °40'10° W(M) ° 126.62'(M) S 89 °40'10° W(P) BB 126.60'(P) Fnd. W Iron Pipe (No Identification) Edge otAsphalt NE 103rd Street (75' Platted Right of -Way) (Asphalt Road) Legal Description: Lot 13, less the North 34.25 feet and all of Lot 14, of Mirror Lake Subdivision, according to the Plat therof as recorded in Plat Book 56, Page 15, Public Records of Miami -Dade County, Florida. . d e a n s&? esiBe3sBa•r eee°galC `db/SNa -Coned= lib* • Pairs atCanapes 'e=p Properties Doses have t been Passeedred aer Ceps. 0valsps, aaltar Cu .Canoreretartanma P.08.. Pleas °fliepblNey Cans .Cmeae Pl]i •RAM m1Lfn° aA. hL. uta cow " -easian--anrUr°aa0Ner.xaoa..,1 2 Lot 15 Field Date: 10/01/09 Eby Corey autidetlouraefy et the . bare tieeafibedP,oper4 Se Tose and Cmreateete Best prosy pm, and Betels' recent' SUTVOyed mrdom) Ctraulon Wino Dabs Based on 1Nbos+adon Foss to ate as rioted one conforms to the h4rdea°nT drdeal anmter8P317.8 Reads Cake, Pa m* b Baadoe.02 A27 t for lad hem Stets ca Melds inaoeaMnce 11/25/2009 14:37 FAX 1 800 885 7530 DATA SCAN FIELD SERVICES 0005/005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP - 128577 Inspection Date: November 25, 2009 Inspector. Devaney, Michael Owner: CLERGE, SABRINA Permit Number: EL -11-09 -1821 I Job Address: 401 NE 103 Street Miami Shores, FL 33138 -2456 Project <NONE> Contractor. CALEX ELECTRICAL CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1122310150130 Phone: 305- 271 -5164 Mike approved but noted that this will require smoke /carbon monoxide detectors.,Use ARC fault B Reukers where require 2 pole ARC fault breakers are approved. Comment in file. Passed Inspector Comments /11 ‹•1 fr)?--- a /v/e2t r Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 November 24, 2009 Page 1 of 1 Miami Shores Village Building Department RE- OCCUPANCY APPLICATION Date 09/14/2009 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No.12 ED £ q - O -6Z2 Loc ID Contact Name JESUS I . MENENDEZ Phone # (305) 794-6931 Buyer Seller Realtor X Company Name COLDWELL BANKER Property Address 401 NE 103rd ST City Miami Shores State Fl Zip 3 313 8 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 Applicant Signature ame JESUS _,;iy, r the foregoing information is accurate. a The foregoing instrument was acknowledged before me this{ U4* day of Ple-O , 20 0 byc U ,S 1 IUevievil - , who is personally known to me or who has produced 'FyP 1 M 015 CD NOTARY PUBLIC: Sign: Print: My Commission Expires: as identification and who did take an oath. Building Officials Approval: (Rev. 10 /02/03) Re -Occ. $60.00 <— Notary $5.00 CCF $0.60 Total $65. • Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 124522 Permit Number: REOC -9 -09 -1522 Scheduled Inspection Date: September 15, 2009 Inspector. Bruhn, Norman Owner: Job Address: 401 NE 103 Street Miami Shores, FL 33138 -2456 Project: <NONE> Contractor: Permit Type: Re- Occupancy Inspection Type: Re Occupancy Work Classification: Re- Occupancy Phone Number Parcel Number 1122310150130 Building Department Comments Passed �lr Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments September 14, 2009 For Inspections please call: (305)762 -4949 Page 12 of 20