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EL-05-410
- :&,` Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 06/30/2006 JUL 0 3 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PALMATIER, LOUISE Work Classification: Addition/Alteration Job Address: 540 103 Street NE Miami Shores Village, FL 33138-2304 Phone Number (305)754-0838 Parcel Number 1132060170900 Project: <NONE> Block: Lot: Contractor: OBI ELECTRIC,INC Phone: 305-651-7179 Building Department Comments Inspector Comments Passed Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Thursday, June 29, 2006 Page 2 of 2 2 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL fiLORIOp' Phone: (305)795-2204 Fax: (305)756-8972 epeiiian Nurge '§*F'k 1070 Por Number: EL2 Inspection Date: 03/03/2006 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Rough Owner: PALMATIER, LOUISE Work Classification: Addition/Alteration Job Address: 540 103 Street NE Miami Shores Village, FL 33138-2304 Phone Number (305)754-0838 Parcel Number 1132060170900 Project: <NONE> Block: Lot: Contractor: OBI ELECTRIC,INC Phone: 305-651-7179 Building Department Comments Inspector Comments Passed Failed El Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid. Thursday, March 2,2006 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)_795.229.4.F 72 BUILDINGAoV , r Permit No. PERMIT APPLICATION er Permit No. FBC 2001 v Permit Type(circle): Building Electrical PI ing Mechanical Roofing Owner's Name(Fee Simple Titleholder) t8 Phone Owner's Address ��Li® citylz o Zip C Tenant/Lessee Name <--I u�-t- Phone# Job Address(where the work is being done) City Miami Shores Villaee County Miami-Dade Zip Is Building Historically Designated YES NOg� ®S n --7/749 Contractor's Company Name~! Phone Contractor's Address / it City State Qualifier � ' (e- State Certificate or Registration No. , Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit Square Footage Of Work: Type of Work E] dit, �bo . epl#Se Demolition Describe Worgv �t� AwOl ell \* J J1-' \ypY1a\Ttf� •gyp�\yf�\yg \' \ •`• � Submittal Fee$ Permit Fee CCF$ 9Z). I . ZO CO/CC. Notary$ Training/Education Fee$ O •40 Technology Fee$ S• -1 5 Scanning$ 3. Q0 Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ • �S NOV 2 2 PAID (Continued on opposite side) cl S 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 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 �&J Signature Own r or gent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged fore me this day of 20_,by day of .20_,by , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTAR PUBLIC: NOTARY PUBL C: Sign: - c �Ile Sign: �o Print: Print: My Commi nr "„ SYDNEY ' sjlotary pubflc•State of Florida My Co Ary PubUc-State of Flodda � pd31,2007 l�Omrn[tsfon6�leeOd312(10 •�,,;r Commie,•„,*' `d�`3'�'b �.. `total E �• WflalSorwlt�OtaryAWL I APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 05/13/03 ADDENDUM TO BUILDING PERMIT APPLICATION AN ArptiCATZON FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS E. OBTAINED, THE OWN'ER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL TEM UNIT FEE ITEM LITFEE ITEM;ATH TUB SWITCH OUTLETSSPACE HEATERS IIDET LIGHT OUTLETS CENTRAL HEATING 1ISHWASHER RECEPTACLES A/C (WIND) )ISPOSAL SERVICE TEMPORARY I A/C (CENTRAL) 3RINKIM FOUNTAIN 'SERVICE SIZE IN AMPS DUCT WORK -LOOR DRAIN SERVICE REPAIRAETER CHANGE REFRIGERATION 3REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING I INTERCEPTOR RANGE TOP UNDERGROUND TANKS _AVATORY OVEN ABOVE (MOUND TANKS "',UNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER I klOTORS C- 1 to STEAM BOILERS SOWER I VOTORS OVER 1- 3 f HOT WATER BOILERS SINK, POT/3 COMP. I f MOTORS OVER 3- 5 f jMECHANICAL VENTILATION I SINK, RESIDENCE I MOTORS OVER 5- 8 P TRANSPORTIN"u ASSEM3LIES SINK, SLIP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 1O- 25 HP FIRE SPRINKLER SYSTEZ URINAL MOTORS OVER 25-100 If COOLING TOWERS WATER CLOSET MOTORS OVER 100 f� VIOLATION I INDIRECT WASTES A/C WINDOW REINSPECTION I I WATER SUPPLY TO: AIR CONDITIONERS A/C UN17 STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS I I HEATER-NEW INST. GENERATORS 'TRANSFORMERS I HEATER-REPLACE I GENERATORS TRANSFORMERS I LAWN SPRINKLER-WELL SPECIAL PURPOSE SWIMAING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS -SIGN TRANSFORMERS UTILITY-SEWER I SIGN TIME CLOCK UTILITY-WATER I FIXTURES SEPTIC TANK ANTENNA RELAY I TELEVISION OUTLETS DRAINFIELD, 4" TILEAES. I VIOLATION I , PUMP & ABANDON SEPTIC TANK REI�GPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL ODM+EST IC WELL I AREA, DRAIN ROOF I FLE i SOLAR WATER HEATER FIRE STANDPIPE ! I E I I I I POOL PIPING { I I I I { LAWN SPRINKLER SYSTEM'. I I I I I I I I GAS RAW,:7 f I I t METER SET (GAS) k l I l I k GAS PIPik• Miami Shores Village 10050 N.E.2nd Avenue glint" Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status:APPROVED Issue Date: 11/22/2005 Expires: 11/21/2006 Permit Number: EL2005-410 Owner's Name: LOUISE PALMATIER one: (305)754-0838 Permit Type: Electrical- Residential Parcel#: 1132060170900 Work Classification: Addition/Alteration Block: Lot: Job Address: 540 103 Street NE Section: PB: Miami Shores Village, FL 33138-2304 Contractor(s) Phone Primary Contractor Total Square Feet: 0 OBI ELECTRIC,INC 305-651-7179 Yes Total Valuation: $ 1,500.00 ommen Re wired Ins ections ADD LIGHT AND PLUGS IN FLORIDA ROOM AlterationUnderground Rough PAID BY CK#2159 ON NOV 22,2005$158.35 WW Service Change Additional Information Meter Box Fire Alarm Type of Work: Additional Info: Relocation Classification:Residential Final Rough In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes- I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. Fees Due Amount Invoice Number Amt Due Amt Paid Total: Total: Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address® /V l� l®� S� Tax Folio Legal Description / Historically Designated: Yes No Owner/ asee/Tenant Master Permit# Owner's Address 5:! �'c) tke 1 zl>g -5: Phone C Contracting Co. Oct-We-yL Address Qualifier SS# - - Phone State# Municipal# Competency# Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one)• UILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN n WORK DESCRIPTIO J,l�� -F,0rif ia.?'t, Square Ft. Estimated Cost(value)( tz?; WARNING TO OWNER YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR BIPROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above,and on the attached addendum(if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore,I authorize the above-named contractor to do the work stated. Signature of owner and/or Condo President Date Si K�on to Owner-Builder Da P63-'?3a - Vt 33Y-® &Y Notary as to Owner and/or Condo President Date Not3dy ad to Contractor ate My Commission Expires: Commission Expir IL=RY SI:UGLA DYS J bILLAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO.CCT!1103 r MY COMMSSION EXP.biP&-i,^NV FEES: PERMIT J V RADON C.C.F. ° o NOTARY _ BOND APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing Structural Engineer �5 0� (411..1 - Iliu R! �\ p� BUILDING AND ZONING DEPAPTMENT j� y ORII9p' 0050 N E. SECOND AVENUE MIAMI STORES. FLORIDA 33138-2382 TELEPHONE (305) 795-2204 FAX (305) 756.8972 October 7, 1997 Mr. Roger Palmatier 540 N.E. 103 Street Miami Shores, FL 33138 Dear -Mr. Palmatier: Your application for an electrical permit was not approved. Electrical permits are not issued to home owners. You will need to make arrangements to have a contractor apply for this permit. If you have any questions, you may contact our electrical inspector, Mike Devaney, by beeper 315-0927. Sincerely, Margar to Montiel Building and Zoning r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address �3 S4 Tax Folio Legal option Historically Designated: Yes No Owner/I.essee/Tenant �l"t �=`Z ?(4 1�=1Z Master Permit# Owner's Address S)7 ti- Phone Contracting Co. �' a F 1 Address L61 PL(0 ( Qualifier SS# - - Phone State# Municipal# Competency# Ins.Co. Architect/Engineer Address Bonding Company Address 'Mortgagor Address Permit Type(circle one): BUILDING (ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 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 work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL,PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore,I authorize the above-named contractor to do the work stated. Signature of owner and/or Condo President Datee o ontr r er-Buil Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner-Builder Date My Commission Expires: My Commission Expires r A FEES: PERMIT RADON C.C.F. NOTARY BOND TOTAL DUES APPROVED: A4 Zoning Building 1 Electrical Mechanical Plumbing Engineering • METRODADE METROPOLITAN DADE COUNTY, FLORIDA _ METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE SUITE 1603 METRO-DADE FLAGLER BUILDING 140 WEST FLAGLER STREET 330-1563 PRODUCT CONTROL NOTICE OF ACCEPTANCE MIAMI, FLORIDA05 )375-2901 FAX(305) 375-2908 Clopay Corporation 312 Walnut St. PRODUCT CONTROL SECTION (305)375-2902 Cincinnati, OH 45202 FAX(305)372-6339 Your application for Product Approval of: 24 ga. Steel Sectional Garage Door 16'--2" wide 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: applicant. For listing see section 7 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 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 meet the requirements of the South Florida Building Code. The expense of such testing will be incurred by the manufacturer. Acceptance No.:95-0303.01 Expires:05/26/98 Raul Rod iguez 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. l CITWd-s-D—anger, Director Building Code Compliance Dept. Approved:05/26/95 4- Metropolitan Dade County Clopay Corp.. ACCEPTANCE No.: 95-0303.02 APPROVED MAY 2 6 1995 EXPIRES MAY 7 6 1998 NOTICE OF ACCEPTANCE: SPECIFIC CONDITION 1. Description: This approves sectional door 16'-2" wide x 6'-6" thru 8'-0" high made out of steel, drawing quality(ASTM A528) galvanized coating of G60 (ASTM A525) finished with baked on polyester paint on both sides. The door shall be constructed and reinforced as detailed in the approved drawing#101300 pages 1 thru 4. Horizontal Reinforcement Track Skin End Stile Center Stile End Hinge Center Hinge Shape Frequency 14GA 24GA 16GA 20GA Double 18GA 16 GA Channel I/Section 14GA 2. Use: This door is approved for a maximum design pressure of+46.6psf& -52.Opsf and its use is restricted to this pressure. The door passed the impact& cyclic test, therefore it does not require hurricane protection devices. The door shall meet the burglary Security requirement of Section 3603.2(c)2(aa) of the South Florida Building Code. The door operating mechanism (not included in this approval) shall be certified by Underwriters Laboratories or other recognized agency. 3. Installation: The door shall be installed as shown on drawings n101300 pages 1 thru 4. Wood in contact with concrete or cement shall be treated with an approved preservative as set forth in paragraph 2913.2(a) 1 or shall be of a durable species as defined in subparagraph 2913.2(a)6(aa) of the South Florida Building Code. Installation of 2" x 6" wood jamb as shown on Page 4/4. Installation of track to 2" x 6" wood jamb requires a '/,,, x is/g lag screws not to exceed @ 14" o/c with a minimum embedment of 1'/,. Candido Font, P.E. Plans Examiner Product Control Division Clopav Cora.. ACCEPTANCE No.: 95-0303.02 APPROVED MAY 2 6 1995 EXPIRES MAY 2 6 1998 NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS 4. Conditions of Use: Application for building permit shall be accompanied by duplicate prints of the approved drawings#101300 pages 1 thru 4 bearing the approval stamp,Notice of Acceptance number and date by the Dade.County Product Control Section along with computations prepared by a qualified Florida Professional engineer or architect verifying the adequacy of the door at each site. The shop drawings shall bear the signature of the architect or engineer with the following statement: "The supporting structure has been designed for the forces shown on the approved manufacturer's drawing." Application for building permit for replacement doors shall be accompanied by duplicate prints of the approved drawing#101300 pages 1 thru 4 bearing the approval stamp, Notice of Acceptance number and date by the Dade County Product Control Section. Also the Building Official must be satisfied that the propose installation meets the use listed on Section 2 above. 5. Limitations: This approval requires the manufacturer to do tensile testing of the finished embossed steel panel doors, fabricated under this Notice of Acceptance. Every three (3) months, four(4) times a year, after previously announcing this office of date, hour and location, the manufacturer shall have a Dade County approved laboratory to cut and test according to ASTM E 8-93, two (2) samples randomly selected from doors fabricated under this Notice of Accceptance located in Dade County. A copy of the test reports and a notarized statement from the manufacturer confirming that samples were selected from doors fabricated under this Notice of Acceptance shall be mailed to our office. If the specimens fail to meet the minimum yield strength of 38,000 PSI, this Notice of Acceptance shall be voided and the manfacturer cannot apply for this model of door for a period of one year. Candido Font, P.E. Plans Examiner Product Control Division -2a- Clopay Corn. ACCEPTANCE No.: 25-0303.02 APPROVED MAY 2 6 1995 EXPIRES MAY 2 6 1998 NOTICE OF ACCEPTANCE:- SPECIFIC CONDITIONS 6. Identification: All approved products shall be permanently Iabeled with the manufacturer's name, city, state and the following statement: "Dade County Product Control Approved." 7. Evidence Submitted: Test Reports Date Drawing Ref. Signature HETI 95-407 01/24/95 101300 H.M. Medina, P.E. HETI 95-408 01/25/95 101300 H.M. Medina, P.E. HETI 95-T59 02/06/95 101300 H.M. Medina, P.E. Calculations Date Signature M.W. Westerfield,P.E. 01/20/95 M.W. Westerfield, P.E. Drawine Number Last Revision Signaturg Clopay B.P. Co. 101300 03/27/95 M.W. Westerfield, P.E. Candido Font, P.E. Plans Examiner Product Control Division -2b- METRODA EE METROPOLITAN DADE COUNTY, FLORIDA - METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE DEPARTMENT SUITE 1603 KIETRO-DADE FLAGLER BUILDING 140 WEST FLAGLER STREET MIAMI, FLORIDA 33130.1563 (305) 375.2901 FAX(305) 375.2908 NOTICE OF ACCEPTANCE: STANDARD) CONDITIONS 1. Extension of Acceptance may be considered after a new application has been filed and the supporting data, test report 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 Elie 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 ,rounds for re-evaluation. -D. This acceptance shall not be used as an endorsement of any product for sales or advertising purposes. �. The Notice of Acceptance number preceded by the words Dade County, Florida, and followed by (lie expiration date may be displived in adyertisin_, literature. 11'any portion of the Notice of:\cccptance is dlspla}'ed. then it sim!l be done in its entirety. 6. A copy of this approval as well as approved drawings and other-documelnts. where it applies, shall be provided to the applicant by the manufacturer of his distributors and shall be available for inspection at the job site at all time. The prints need not be re-sealed by the engineer. 7. Failure to comply with Standard Conditions shall be cause fur termination of:Approval. r— C ul IZ��dri�,uei Product C Ontrol Supervisor JE3/27/75 "TE DESCRIPTIONMODELS 83, 84A, 87, 93, 94, 97 18 GA. GALV. DOUBLE ENDSTILES ADA JAMB DwG 4 CNR r ro P,4GE 4 ATTACHED TO TOP AND BOTTOM RAIL WITH PATENTED TOG—L—LOC SYSTEM. 16 GA. PAINTED END STILES ATTACHED TO DOOR ONE INTERMEDIATE STILE BETWEEN EACH EMBOSS LOCATION. SKIN WITH PATENTED TOG—L—LOC SYSTEM ATTACHED W/ PATENTED TOG—L—LOC SYSTEM (TOP & BOT) (TDP. BOTTOM 8c CENTER). AND URETHANE ADHESIVE (ALONG CENTER) SNAP LATCH ENGAGES /\ - ---�-A ONTO VERTICAL TRACK. - - ONE. SNAP LATCH ON EACH SIDE OF DOOR. VIEW "C" INTER. STILE . . ° VIEW "B" � I OUTSIDE KEYED END ao HANDLE STILE 46II ° ° LOCK .PDSlTl0�1 - (BOTH SIDES) INSIDE HANDLE m TWO POINT LOCKING OUTSIDE KEYED LOCK I CONFORMS TO SFBC SNAP LATCH LOCK OPTION z 3603.2 REGARGING CONFORMS TO SFBC 3603.2 'm GARAGE DOORS WITH o ° ° ° 5/8" MIN. ENGAGEMENT. o DOOR TESTED FOR SLIDE BOLT END FORCED ENTRY WITH STILE LOCK ENGAGES I BOTH OUTSIDE KEYED INTO VERTICAL LOCK AND INSIDE TRACK. ONE __ — -- --- — SLIDE BOLT LOCK LOCK =-- OPTIONS (SEE EACH SIDE LAYOUT OF EACH OF DOOR. - --�A OPTIONAL OUTSIDE KEYED LOCK POSITION LOCK ON THIS PAGE). INSIDE SLIDE BOLT MAX. DOOR WIDTH = 16'-2LOCK OPTION " END CONFORMS TO SFBC 3603.2 LOCATION OF OPTIONAL VENTS INSIDE ELEVATIONS INTER. STILE SCALE 1 f 2" =.i' STILE LOCK BAR DESIGN ENGINEER GUIDE MARK W. WESTERFIELD, P.E. OUTSIDE AppROVED AS COMPLYING WITH THE FLORIDA REGISTRATION No. 48495 HANDLE SOUTH FLORIDA BUILDING CODE INSTALLER RETAIL LOCK BAR DAT- er 19'-75 MODEL MODEL DESCRIPTION ENGAGES IN B' 9383 WOODGRAIN TEXTURE, RAISEDPANEL,' GALV. INTER. STILES TRACK ON PRODUCT CONTROL DIVISION 94 97 84A, 87 WOODGRAIN TEXTURE RAISED PANEL PAINTED GALV. INTER. STILES OUTSIDE KEYED LOCK EACH SIDE BUILDING CODE CDA9PLIANCE OFFICE LOCK BAR LOCKING OF DOOR. ACCEPTANCE No OTE CONFORMS TO SFBC 3603.2 DOORS UP TO 7'-0" HIGH CONSIST OF 4) SECTIONS (SHOWN) DOORS OVER 7'-0" HIGH CONSIST OF (5) SECTIONS (NOT SHOWN). CLUPAY BUILDING PRODUCTS COMPANY NOTED P"` ' ►+nx D°°R,u „ 010Hpay 312 WALNUT STREET, SUITE 1600 1 OF 416 2' W x 8 0 CINCINNATI, OHIO 45202 DAM 2/15/95 DESCRIPTION DESIGN LOADS: +46.6 P.S.F. & -52.0 P.S.F. Bullding Products (513) 381-4800 4. MAW ,r• Mww DOUBLE CAR HURRICANE PAN DOOR B oRA��a N Rte, TEST LOADS: +70.0 P.S.F. & -78.0 P.S.F. Company 00W Carp—G- AS �M* R.Mrved aCWCKO 101300 E MODELS 83, 84A, 87, 93, 94, 97 REV DATE — DESCRIPTION 1 13/Z7/V Abb6b 1Am.8 1w6 4 cNA ry P 2" THICK --1 f-- 12 GA. GALV. STEEL TOP ROLLER BRACKET. EACH BRACKET ATTACHED W/(4) #14x5/8" SHEET METAL SCREWS. ADJUSTTABLE SLIDE ATTACHED TO TOP BRACKET WITH (2) 1/4!'x1/27 BOLTS AND NUTS PER BRACKET. � g" SHIP LAP JOINTS. 2-1/2" _ -4 -5/8, VIEW "D" 6" TALL C-CHANNEL 16 GA. GALV. STEEL O ' 14 GA. GALV. ROLLER HINGE. EACH HINGE FASTENED TO END STILES W/(4) #14x5/8" SHEET METAL AND (4) 1/4'x3/4!' SELF* TAPPING SCREWS. (SEE VIEW "B") ONE 6" TALL C-CHANNEL PER DOOR SECTION. (SEE VIEW "D") C-CHANNEL ATTACHED AT EACH STILE LOCATION WITH • (1) 1/4"x3/4" SELF TAPPING SCREW. 24 GA. STEEL (MIN. YIELD STRENGTH. 38 KSI) EXTERIOR SKIN WITH G-60 GALVANIZING, BAKED-ON PRIMER AND A 1-1/4!* WIDE x 16 GA. GALV. STRAP. (7) PER BAKED-ON POLYESTER PAINTED TOP COAT DOOR SECTION, EXCEPT (8) STRAPS ON 2ND APPLIED TO BOTH SIDES. OF STEEL SKIN. SECTION (SEEINSIDE ELEVATION). EACH STRAP ATTACHED APPROVED AS COMPLYING WITH �►( (ASTM No. A653). WITH (3) 1/4!'x3/4!' x3/4 SELF TAPPING SCREWS (TWO SCREWS TO DOOR; ONE SCREW TO C-CHANNEL). SOUTH FLORIDA BUILDING CODE DATE I = 13 GA. GALV. STEEL BOTTOM BRACKET. sr _ ATTACHED, WITH (2) #14x5/8" SHEET METAL SCREWS. PRODUCT CONTROL DIVISION BUILDING CODE COMPLIANCE OFFICE DESIGN ENGINEER ACCEPTANCE NO.951 .4 ALUMINUM EXTRUSION & VINYL WEATHERSTRIP. MARK W. WESTERFIELD, P.E. FLORIDA REGISTRATION No. 48495 CLOSECTION A-A (SIDE VIEW) �, PAS, HAX DDDR SIZES SCALE 2" = 1 ' ® clapa 312 W BUILDING•PRODUCTS COMPANY NOTED 2 OF 4 16'2"W x 8'0"H 312 WALNUT STREET, SUITE 1600 ��' DESIGN LOADS: +46.6 P.S.F. & .-52.0 P.S.F. ® � CINCINNATI, OHIO 4s2o2 2/15/95 DESCRIPTIDK 1 513) 381-4800 DUVN BY, MWW DOUBLE CAR HURRICANE PAN DOOR TEST LOADS: +70.0 P.S.F. & -78.0 P.S.F. BREM Products DR,%WM W"Cit. RE Com Q n 00M Capertltlon NI Right* RNvr.,W. CHECKED BY, B 101300 REV DAIS DESCRIPTIDN MODELS 83, 84A, 87, '93, 94, 97 1 3 z2q5 Abb6b IAMB bW6 I CHAKT ro PAGE 4 #14x5/8" SHEET METAL SCREWS HORIZONTAL TRACK SUPPORT BY O DOOR INSTALLER (TO SUIT) „ O O DOOR COUNTERBALANCE SYSTEM . • o 00 O O -' o 1/4%3/4-"x3/4" SELF O O TAPPING SCREWS. ' 12 GA. GALV. STEEL CONTINUOUS 14 GA. END HINGES 18 GA. INTERMEDIATE HINGE 1 -5/8" x 2-3/8" ANGLE. SCALE 2" = 1 ' SCALE 2" = 1 ' _ VIEW "B" IE-z EW — � w JAMB PREPARATION NOTE = TRACK CONFIGURATION EACH CONTINUOUS ANGLE TRACK SHALL BE FASTENED TO PRESSURE TREATED 2x6 YELLOW SCALE 1/2" = 1' DOOR PINE WOOD JAMBS WITH 5/16"x1 -5/8" LAG SCREWS (12) LAG SCREWS PER SIDE UP TO O " " 7'0" HIGH AND (13) LAG SCREWS PER SIDE UP TO 8'0" HIGH). THE METHOD OF ATTACHMENT n _ HEIGHT 7p TO THE SUPPORTING STRUCTURE OF THE PRESSURE TREATED 2x6 WOOD JAMBS SHALL BE II 7'-0' - 76 APPROVED BY THE PROFESSIONAL OF RECORD FOR THE STRUCTURE AND IN ACCORDANCE WITH 2" GALV. STEEL TRACK, 7'-6" 82' CURRENT BUILDING CODES FOR THE LOADS LISTED ON THIS DRAWING OR AS SHOWN = TRACK THICKNESS: .083" 8'–p gg ON PAGE 4 OF THIS DRAWING. PREPARATION OF JAMBS BY OTHERS. w "L" 10 z ALL MOUNTING OF TRACK, ANGLES, HORIZONTAL TRACK SUPPORTS, AND ALL OTHER 0 DOOR HARDWARE TO BE INSTALLED PER CLOPAY INSTALLATION INSTRUCTIONS Z TYP. 2-1/27x`12 GA. GALV. SUPPLIED WITH DOOR SYSTEM UNLESS OTHERWISE NOTED. w STEEL TRACK CLIPS. 1" DOOR OVERLAP (EACH SIDE) o DISTANCE BETWEEN BRACKETS STOP MOULDING BY DOOR INSTALLER (TO SUIT) NOT TO EXCEED 14" O.C. 16 GA. GALV. STEEL PAINTED END STILE (7 TOTAL CLIPS FOR DOORS 2x6 WOOD JAMB ;;; ;, ;, 18 GA. GALV. STEEL DOUBLE END STILE UP TO 7'0" HIGH). SEE JAMB PREPARATION ;, , :. (8 TOTAL CLIPS FOR DOORS NOTE" ABOVE " " " ' " '."" " " ' 20 GA. GALV. STEEL INTER. STILE UP TO 8'0" HIGH). 12 GA. GALV. STEEL CONTINUOUS ANGLE FASTENED TO WOOD JAMB WITH 5/16-0-5/8" LAG SCREWS NOT TO EXCEED 14" O.C. CONTINUOUS 7/16" NUT IS INSTALLED 18 GA. GALV. STEEL CENTER HINGE APPROVED AS COMPLYING WITH THE ANGLE MAY BE NOTCHED OUT AT JAMB ON ROLLER SHAFT FOR FASTENED TO INTER. STILES W/(4) TO STRUCTURE ATTACHMENT POINTS. UNRESTRICTED OPERATION. EACH #14x5/8" SHEET METAL SCREWS. SOUTH FLORIDA BUILDING CODEC , DAT E— 19� 2" GALV, STEEL TRACK FASTENED 14 GA. GALV. STEEL ROLLER HINGES _ FASTENED TO END STILES W/(4) EACH DY_"_ �� PRODUCT Cit:T20'_ DIV.SIOY I TO 12 GA. GALV. STEEL TRACK . CLIPS. 14x5/8 SHEET METAL SCREWS AND PRODUCc CURE COMPLIANCE OFFICE TRACK ATTACHED TO EACH CLIP 112) 1/4- SELF TAPPING SCREWS PER END HINGE. WITH TWO 1/4"'x5/8" BOLTS & NUTS, DESIGN ENGINEER ACCEPTI`.t:CE ND. q�,'[1'f).OPi EACH TRACK CLIP ATTACHED TO 2" DIA. LONG STEM, 10 BALL STEEL ROLLER. MARK W. WESTERFIELD, P.E. CONTINUOUS ANGLE WITH END OF ROLLER STEM THREADED FOR FLORIDA REGISTRATION No. 48495 (2) 1/4" DIA. RIVETS PER CLIP. 7/16" NUT. CLOPAY BUILDING PRODUCTS COMPANY S`"LE' NOTED PAMr` �l 'W ® 810pay 312 WALNUT STREET, SUITE 1600 / 3 OF 4 16'2W x 8'0"H CINCINNATI, OHIO 45202 DAM2/15 95 DE=TPTIow JAMB CONFIGURATION ® (513) 381--4800 MAVN V6 MWW DOUBLE CAR HURRICANE PAN DOOR DESIGN LOADS: +46.6 P.S.F. & –52.0 P.S.F, SCALE 2" 1' Building Products DRAvim NUMBER, REM TEST LOADS: +70.0 P.S.F. & –78.0 P.S.F. Company . aevcW C-p—ebn M M" Rauv.4. cFIECKEn BY, B 1 101300 1 / ` MODELS 83, 84A, 87, 93, 94, 97 REv DATE DESCRIPTION 1 13/27/95 ADDED JAMB DWG & CHART TO PAGE 4 2x6 JAMB TO SUPPORTING STRUCTURE ATTACHMENT NOTES: 1) ALL THE LOAD FROM THE DOOR IS TRANSFERRED TO THE TRACK AND THEN FROM THE TRACK HORIZONTAL JAMB TO THE 2x6 VERTICAL JAMBS (GRADE 2 OR BETTER YELLOW PINE). NO LOAD FROM THE : (NO LOAD FROM DOOR) DOOR IS TRANSFERRED TO THE HORIZONTAL (TOP) JAMB. -2) EACH VERTICAL JAMB SEES .A MAXIMUM DESIGN LOAD OF +2,982.4 LB & —3,328 LB AND A MAXIMUM TEST LOAD OF 4,480 LB & —4,992 LB. ° 3) ALL JAMB FASTENERS MAY BE (BUT NOT REQUIRE) COUNTERSUNK TO PROVIDE A FLUSH MOUNTING SURFACE. WOOD FRAME BUILDINGS 4 ° STUD WALLS OF DOOR OPENING SHALL BE FRAMED SOLID BY NOT LESS THAN (3) 2x6 PRESSURE FASTENER TREATED GRADE #2 OR BETTER WOOD STUD OF A STRESS GRADE NOT LESS THAN 1200 PSI NOMINAL TYPE EXTREME FIBER STRESS IN BENDING (Fb). STUD WALLS TO BE CONTINUOUS FROM FOOTING TO TIE BEAMS MIN. No. AND IN ACCORDANCE WITH SFBC SECTION 2905.1. OF FASTENERS PER VERTICAL BLOCK WALL OR CONCRETE _ : JAMB 2x6 WOOD JAMB SHALL BE ANCHORED TO GROUT REINFORCED BLOCK WALL OR CONCRETE COLUMN. MAX. 0.C. 2x6 VERTICAL JAMB BLOCK WALL CELLS SHALL BE FILLED WITH CONCRETE AND REINFORCED WITH #5 BAR EXTENDING INTO THE FOOTING AND INTO TIE BEAMS. ALL BARS SHALL BE CONTINUOUS FROM THE TIE BEAMS ° TO FOOTING PER BLOCK WALL OR CONCRETE COLUMN. BLOCK WALLS AND CONCRETE COLUMNS TO BE DESIGNED BY BUILDING PROFESSIONAL OF RECORD AND IN ACCORDANCE WITH SFBC SECTION 2704.2. 2x6 JAMB TO SUPPORTING STRUCTURE ATTACHMENT ° (NOT TO BE USED FOR ATTACHMENT OF TRACK ANGLE TO 2x6 VERTICAL JAMBS OR SUPPORTING STRUCTURE) MAXIMUM MIN. No. OF ON CENTER FASTENERS DISTANCE STEEL PER VERTICAL BETWEEN WASHERS BUILDING TYPE FASTENER TYPE JAMB FASTENERS REQUIRED? WOOD FRAME 1 /27 x 3" EMBED LAG SCREW ASTM A3O7 GRADE A 6 16" YES BLOCK WALL OR CONCRETE 1/4" x 1-3/4" MIN. EMBED TAPCON CONCRETE ANCHOR 8 12" YES BLOCK WALL OR CONCRETE HILTI SDM--72-536 PINS WITH 1 -1/2" EMBED 9 10-1/7 YES APPROVED AS COMPLYING WITH TNF BLOCK WALL -OR CONCRETE-W8- x T::-3-/4:' MIN. EMBED RAWL—STUD EXPANSION ANCHOR 7400 SERIES 5 1 gNO SOUTI� FLORIDA BUILDING CODE BLOCK WALL OR CONCRETE 13/8" x 1 -3 4" MIN. EMBED RAWL LOK BOLT ANCHOR BOLT 5000 SERIES ,5 19 NO DATE— BY PRODUCT CONTROL DIV;S;ON DESIGN ENGINEER BUILDING CODE COWPLIA,�(CEOFFICE MARK W. WESTERFIELD, P.E. A..CCEPTANCE Iao G5-0l 63' )J. -,FLORIDA REGISTRATION No. 48495 .1 ® CLOPAY BUILDING PRODUCTS COMPANY sc-LE' PAGE, w+x aoaR srzE ® 010pay312 WALNUT STREET, suITE tsoo TED 4 OF 4 16'2"W x 8'0"H CINCINNATI, OHIO 45202 DATE, 2/15/95 DESCRIPTION DESIGN LOADS: +46.6 P.S.F. & —52.0 P.S.F. Building Products (513) 381-4800 DRAWN BY. MWW DOUBLE CAR HURRICANE PAN DOOR CHECKED BYE DRAVING NUMBER, REV. TEST LOADS: +70.0 P.S.F. & —78.0 P.S.F. Company carol• �rp°�° An Rights R.rtrv.d. B 101300 U�/.•1 ire'. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE r Date_4; Job Address (� � Tax Folio Legal Description Owner "/ Lessee / Tenant Master Permit # _12 7le-W Owner's Address— '5w) Z Phone �✓ S� �(/ O��U Contracting Co. Address X1 W , Qualifier3 — State P DDOD� cip'al �p Competency Ins.Co. '/�L/2� Architect/Engineer Addre Bonding Company Address Mortgagor Address Permit Type{circle one) : BUILDIN ELECTRICAL PL ING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost(value) Z `4ARNING 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I ;aut;,hno ' ethe above-named n racto o do the work stated. f e o owner d/or Condo President ignature of Con actor or Owner-Builder te. Date: Notary as t Q�cfl�r� grid/ar��-Condc ''Px�es�i ent Notary s ��SY ebtbrbtdr°"day er- uilder a M k My Commissl I �E�plrc��: My Comm �.7fpl5kRYlf 7 w FEES: PERMIT RADON C.C.F. _ NOTARY TOTAL DUE._-��, APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering APPLICATION FOR CONTrCACTOI IS LICENSE MIAMI SHORES VILLAGE FLORIDA Date 7/2- Name 2- Name of Company or Corporation Address P - -4111--t I--): C Y 1,4 L F Phone Street No. or P. 0. Box City Name of Owner z� � �,2 - Phone (If a firm, the names of all members of the firm; if a corporation, the names of all officers of the corporation.) Nature of Business og �; , ,� �,� ;f Names and Numbers Employees (Masters and Journeymen): License Number other Municipalities: Name and Amounts Insurance Carried: Financial References: J (Signed) �,�� wner Sworn to and Subscribed Before mei NOTARY PUBLIC m State of Florida My Commission Expires A F F I D A V I T STATE OF FLORIDA) SS COUNTY OF DADE of the Village of Miami Shores, County of Dade and State of Florida, being duly swornv doth depose and say, that under the provisions of Ordinance No. 1859 dated Julie 159 1948, amending paragraph (d) of Section B-368 of Ordinance No. 97 of the Building Code of Miami Shores Villageo he desires to build a 31 -, on Lot Block of t f a 18& fiv.,Subdivision, that he is the owner of said property, and will be the owner of said - I te 2 that he will do the work personally, and that he will, at such times as are required by the Zoning and Building Director: - - 1. File plans and specifications and obtain approval of the Planning Board and the Building Inspector. 2. Apply for and secure a Permit. 3. Pay the required fees. 4. Execute the work in accordance with the provisions of this Code. 5. Apply for inspections. 6. File with the Building Inspector certificates that provision has been made to carry the necessary 11orkmen's Compensation, Public Liability and Property Damage Insurance. 7. File with the Building Insper.tor as the job progresses certificates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume the responsibility of not employing other than properly licensed contractors by Niw-a3. Shores Village for any part or portion of the work. 9. Not set himself up as a "contractor". 10. Sign an affidavit before commencing work to the effect that he has read this Article and will do the work personally and observe all of the requirements of the Building, Electrical, Plumbing and Zoning Codes of Miami Shores Village. Such affidavit to be properly notarized upon blanks to be supplied by the Building Inspector. 11. In order to prevent abuses and subterfuge the right of such owner-builder as herin provided, is limited to but one o�,7ner- builder permit each 2 years, and where an owner-builder flas once exercized the privilege herein conferred no second applica- tion for owner-builder permit shall be granted in less than 2 yearsp unless the applicaiz.l_ is qualified as a licensed General Contractor under the applicable Ordinances of said Village. And Further this Deponent says not: 1N SUBSCRIBED AND S14ORN TO BEFORE ME this 2,-2- day of A.D., 195 NOTARY PUBLIC No Changes may be made in the Wording of this Form except by Endorsement. No. 248-P6 DWELLING BUILDING (S) SPECIAL FORM Florida (Edition 2-00) (Dwelling Building(s) Only—Deductible Clause Applicable Except to Certain Specified Perils) IMPORTANT—It is a condition of this insurance that no building covered hereunder is occupied by more than four families. Insurance under this form attaches only to those items defined in this form and described on the first page of this policy for which an amount is shown in the space provided therefor and not exceeding said amount except as otherwise specifically pro- vided- in Section V under paragraphs A and C. Any loss hereunder shall not reduce the amount of this policy. In the application of the provisions of this policy, including endorsements (but not this form), to the perils insured against by this form, wherever the word "fire" appears there shall be substituted therefor the peril involved or the loss caused thereby, as the case requires. All provisions of this form and of the policy to which it is attached shall apply separately to each item covered, except as otherwise specifically provided. SECTION I—COVERAGE This policy insures against all risks of physical loss, except as hereinafter excluded,to the described property, subject to the provisions of this form and of the policy to which this form is attached including endorsements thereon. SECTION II-EXCLUSIONS THIS POLICY DOES NOT INSURE AGAINST LOSS— respect to maintaining heat in the building(s) or unless such A. By termites or other insects; wear and tear; deterioration; systems and appliances had been drained and the water supply smog; smoke from agricultural smudging or industrial opera- shut off during such vacancy or unoccupancy; tions; rust; wet or dry,rot; mould; mechanical breakdown; set- I. By vandalism and malicious mischief, theft or attempted tling, cracking, shrinvege, bulging or expansion of pavements, theft, or glass breakage, if the described property had been foundations, walls, floors, or ceilings; unless loss by fire, smoke vacant beyond a period of thirty (30) consecutive days immedi- (other than smoke from agricultural smudging or industrial ately preceding the loss; operations), explosion, collapse, water not otherwise excluded, or glass breakage ensues, and this Company shall then be liable J. To retaining walls not constituting part of a building when only for such ensuing loss; such loss is caused by the pressure of ice or water; B. By earthquake, landslide or other earth movement; unless K. By fire caused, directly or indirectly, by: (a) enemy loss by fire or explosion ensues, and this Company shall then be attack by armed forces, including action taken by military, naval liable only for such ensuing loss; or air forces in resisting an actual or an immediately impending C. Caused by, resulting from, contributed to or aggravated enemy attack; (b) invasion; c) insurrection; (d) rebellion; (e) by any of the following—(a) flood, surface water, waves, tidal revolution; (f) civil war; or tg) usurped power. water or tidal wave, overflow of streams or other bodies of By any peril other than fire caused, directly or indirectly, by: water, or spray from any of the foregoing, all whether driven by (a) hostile or warlike action in time of peace or war, including wind or not; (b) water which backs up through sewers or action in hindering, combating or defending against an actual, drains; (c) water below the surface of the ground including that impending or expected attack, (1) by any government or sover- which exerts pressure on or flows, seeps or leaks through side- eign power (de jure or de facto), or by any authority maintain- walks, driveways, foundations, walls, basement or other floors, ing or using military, naval or air forces; or (2) by military, or through doors, windows or any other openings in such side- naval or air forces; or (3) by an agent of any such government, walks, driveways, foundations,walls or floors; unless loss by fire power, authority or forces, it being understood that any dis- or explosion ensues, and this Company shall then be liable only charge, explosion or use of any weapon of war employing nuclear for such ensuing loss; fission or fusion shall be conclusively presumed to be such D. Occasioned by enforcement of any local or state ordi- a hostile or warlike action by such a government, power, nance or law regulating the construction,repair, or demolition of authority or forces; (b) insurrection, rebellion, revolution, civil building(s) or structure(s) unless such liability is otherwise spe- war, usurped power, or action taken by governmental authority cifically assumed by endorsement hereon; in hindering, combating or defending against such an occurrence. E. By theft of any property: (1) which at the time of loss Nuclear Clause: The word "fire" in this policy or en- is not an integral part of any dwelling building or private strut- dorsements attached hereto is not intended to and does not em- ture; (2) from a building in process of construction; unless loss brace nuclear reaction or nuclear radiation or radioactive con- by fire, smoke, explosion, water not otherwise excluded or glass tamination, all whether controlled or uncontrolled, and loss by breakage ensues from theft or attempted theft, and this Com- nuclear reaction or nuclear radiation or radioactive contamina- pany shall then be liable only for such ensuing loss; tion is not intended to be and is not insured against by this F. By contamination; policy or said endorsements, whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused G. By windstorm and hail to the following property, unless by, contributed to, or aggravated by "fire" or any other perils liability therefor is assumed on the first page of this policy by insured against by this policy or said endorsements; however, separate and specific item(s) or by endorsement hereon: (1) subject to the foregoing and all provisions of this policy, direct cloth awnings and their frames, (2) fences, (3) seawall, property loss by `.`fire" resulting from nuclear reaction or nuclear radia- line and similar walls, (4) greenhouses, hot houses, slathouses, tion or radioactive contamination is insured against by this trellises, pergolas, cabanas and outdoor equipment pertaining to policy. the service of the premises, (5) wharfs, docks, piers, boathouses, bulkheads or other structures located over or partially over Nuclear Exclusion: (This clause applies to all perils in- water and the property therein or thereon, (6) trees, shrubs and sured against hereunder except the perils of fire and lightning, plants, (7) screening and supports enclosing or partially enclos- which are otherwise provided for in the Nuclear Clause): Loss ing pools, patios or other areas, whether a separate structure or by nuclear reaction or nuclear radiation or radioactive contami- attached to a building; however, nothing in exclusion (7) shall nation, all whether controlled or uncontrolled, or due to any act be construed to exclude loss to screening and supports of or condition incident to any of the foregoing, is not insured porches which are a part of dwellings; against by this policy, whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused by, con- H. To plumbing or heating systems or their appliances, or tributed to, or aggravated by any of the perils insured against by by leakage or overflow from such systems or appliances, caused this policy; and nuclear reaction or nuclear radiation or radio- by freezing while the described building(s) is vacant or unoccu- active contamination, all whether controlled or uncontrolled, is pied, unless the Insured shall have exercised due diligence with not "explosion" or "smoke". SECTION III—DEDUCTIBLES No. 1—(Applicable only to loss caused by Windstorm, Hail) Hail which is subject to Deductible No. 1, exceeds fifty dollars —This Company shall be liable only when the aggregate amount ($50.00) in any one occurrence and then only for its proportion of Windstorm or Hail loss to each dwelling, its outbuildings, of the excess. This deductible,however,shall not apply to loss by structures, antennas and their towers, and if covered hereunder, fire; lightning; smoke; explosion; riot; riot attending a strike; trees, shrubs and plants, exceeds one hundred dollars ($100.00) civil commotion; aircraft; vehicle; sudden or accidental tearing eany one occurrence and then only for its proportion of such asunder, cracking, burning, or bulging of steam or hot water excess. g. g, g g No. 2—(Applicable onl to loss b heating systems (except appliances for heating water for domes- No. y y peril(s) NOT named tic consumption); vandalism and malicious mischief; or theft or herein, excepting loss resulting from Windstorm or Hail which attempted theft. is subject to Deductible No. 1)—This Company shall be liable only when loss to property covered hereunder resulting from Rental Value and Additional Living Expense are not sub- peril(s) not named herein, excepting loss from Windstorm or ject to the application of Deductible clauses No. 1 or No. 2. THE PROVISIONS PRINTED ON THE BACK OF THIS FORM ARE HEREBY REFERRED TO AND MADE A PART HEREOF. CAUTION: WHEN THIS FORM IS ATTACHED TO ONE FIRE POLICY, THE INSURED SHOULD SECURE LIKE COVERAGE ON ALL FIRE POLICIES COVERING THE SAME PROPERTY. SECTION IV-DEFINITIONS A. Dwelling: This term shall mean any building including additions in such order is given as a direct result of damage to neighboring premises by contact therewith, occupied principally for dwelling house purposes; also, if a peril insured against. the property of the owner of the described dwelling and when not otherwiseD. Additional Living Expense: This term shall mean the necessary covered, building equipment, fixtures and outdoor equipment, all pertaining increase in living expense incurred by the Insured in order to continue as to the service of the described premises and while located thereon; also, nearly as practicable the normal standard of living of the Insured's house- materials and supplies located on the described premises or adjacent thereto, hold for the applicable period described in (1) or (2) and not limited by intended for use in construction, alteration, or repair of structures covered the expiration date of this policy; (1) the time required, with the exercise of due diligence and dispatch, to repair or replace the damaged or destroyed hereunder. property; (2) the time required for the Insured's household to become settled B. Private Structures: This term shall mean those appertaining to the in any permanent quarters. described premises and located thereon but not structures used in whole or This Company shall also be liable for the necessary increase in living in part for commercial, manufacturing, or farming purposes, nor any struc- expense, during the period of time, not exceeding two weeks, while access tares (except structures used for private garage purposes) which are wholly to the described premises is prohibited by order of civil authority, but only rented or leased to other than a tenant of the principal dwelling covered when such order is given as a direct result of damage to neighboring prem- hereunder. ises by a peril insured against. C. Rental Value: This term shall mean the fair rental value of the E. Trees,Shrubs or Plants: Coverage on Trees,Shrubs or Plants,other building(s) or parte thereof, as furnished and equipped by the owner, and than provided in paragraph B, Section V, shall mean those appertaining to the described premises and located thereon (except those grown for com- :rhether rented or not. Loss of Rental Value shall be computed for the period of time, following loss, which would be required with the exercise of grpurposes) against loss tr fire, lightning, smoke (except smoke from a due diligence and dispatch, and not limited by the expiration date of this agricultural ltural smudging or industrial operations), windstorm, hail, explosion, policy, to restore the property to a tenantable condition, less such charges riot,riot attending a strike, civil commotion,aircraft, falling objects, vehicles and expenses as do not continue. (except vehicles operated by an occupant of the described premises), collapse of a building, vandalism and malicious mischief, and damage by burglars This Company shall also be liable for the actual loss of Rental Value, (except with respect to property taken from the premises), but this Company during the period of time, not exceeding two weeks, while access to the shall not be liable for more than its proportion of two hundred and fifty described premises is prohibited by order of civil authority, but only when dollars ($260.) on any one tree, shrub or plant. SECTION V-EXTENSIONS OF COVERAGE A. Private Structures: The Insured may apply up to ten per cent per cent (80%) of the full replacement cost of such building structure, this (10%) of the amount of insurance specified for the principal dwelling item Company's liability for lose under this policy shall not exceed the larger of under this policy as an additional amount of insurance to cover Private the following amounts (a) or (b)— Structures as defined in Paragraph B of Section IV against loss by any (a) The actual cash value of that part of the building structure damaged peril insured against. or destroyed; B. Trees, Shrubs, Plants and Lawns- The Insured may apply ap (b) That proportion of the full cost of repair or replacement without to five per cent (6%) of the amount of insurance specified for the princi. deduction for depreciation of that part of the building structure pal dwelling item under this policy to cover trees, shrubs and plants on the damaged or destroyed, which the whole amount of insurance ap- described premises (except those grown for commercial purposes) against heable to said building structure for the loss by fire, lightning, smoke except smoke from agricultural smudging or ppb perilcausingeco the loss industrial operations), explosion, riot, riot attending a strike, civil commo- building eighty cent (80%) of the fall replacement cost of such tion, aircraft, vehicles (except vehicles operated by an occupant of the de- scribed premises), collapse of a building, vandalism and malicious mischief, 4. This Company's liability for loss under this policy including this and damage caused by theft or attempted theft (except with respect to Extension of Coverage shall not exceed the smallest of the following amounts property taken from the premises), but this Company shall not be liable for (a), (b), or (c)— more than its proportion of two hundred and fifty dollars ($260.) on any (a) The amount of this policy applicable to the damaged or destroyed one tree,shrub or plant, In no event shall the coverage under this extension building structure; apply to the perils of windstorm and hail nor any other risk of physical loss except those specifically set forth in this paragraph. (b) The replacement cost i th the building structure or any part thereof identical with such building structure on e same premises and The insurance specified for the principal dwelling item under this policy intended for the same occupancy and use; shall also apply to lawns but only against loss by the perils named in the (c) The amount actually and necessarily expended in repairing or re- preceding paragraph. placing said banding structure or any part thereof intended for the C. Rental Value and Additional Living Expense: The Insured may same occupancy and use. apply up to ten per cent (10%) of the amount of insurance specified for This Company shall not be liable under paragraph (2) or sub-paragraph the principal dwelling item under this policy as an additional amount of (b) of paragraph (8) of this Extension of Coverage for any loss unless and insurance to cover loss (where such loss is by any peril insured against) until actual repair or replacement is completed. of both (1) Rental Value of the described building(s) with respect to any portion thereof not occupied by the Insured and (2) Additional Living Ex- B. The Insured may elect to disregard this Extension of Coverage in pense with respect to any portion of the described building(s) occupied by making claim hereunder, but such election shall not prejudice the Insured's the Insured, but not to exceed said ten per cent (10%) for both (1) and (2) right to make further claim within one hundred twenty (120) days after loss in the aggregate. for any additional liability brought about by this Extension of Coverage. D. Replacement Cost Coverage: As respects building structures (mean- As respects Extension of Coverage A, B. C and D— ing thereby only property which at the time of loss is an essential part of It is a condition of this policy that in the event the Insured elects to any building structure)— apply the optional Extension of Coverage herein this Company shall not 1. In the event of loss to a building structure covered under this policy, be liable for a greater proportion of any loss than would have been the when the full cost of repair or replacement is both(a)less than One Thousand case if all policies covering the described property had contained identical Dollars ($1,000.00), and (b) leas than five per cent (6%) of the whole optional provisions and the same election were made under all policies. amount of insurance applicable to such building structure for the peril causing E. Debris Removal: This insurance covers the loss, the coverage of this policy is extended to include the fall coat of removal of all debris of the expenses incurred in the repair or replacement without deduction for depreciation. property covered hereunder which may be occa- sioned by lose caused by any of the perils insured against in this policy. 2. If at the time of loss the whole amount of insurance applicable to However, the total liability under this policy for both loss to property and said building structure for the peril causing the loss is eighty per cent (809o') removal of debris shall not exceed the amount of insurance applying under or more of the full replacement cost of such building structure, the coverage this policy to the property damaged or destroyed. of this policy applicable to such building structure is extended to include the F. Off Premises Coverage: This policy is extended to cover pro rata full cost of repair or replacement without deduction for depreciation. for thirty days at each proper place to which any of the property covered 8. If at the time of loss the whole amount of insurance applicable hereunder shall be necessarily removed for preservation from or for repair to said building structure for the peril causing the loss is less than eighty of damage caused by a peril insured against. SECTION VI-OTHER PROVISIONS A. Control of Property: This insurance shall not be prejudiced by any deductible, if any, than the amount hereby insured bears to all insurance, act or neglect of any person (other than the named Insured), when such whether collectible or not, covering in any manner such lose, or which would act or neglect is not within the control of the named Insured. have covered such loss except for the existence of this insurance; except if B. Theft: The policy condition excluding loss by theft is hereby any type of insurance other than fire extended to cover additional perils or waived, except as provided in Section II, Paragraph E of this form. windstorm insurance applies to any loss to which this insurance also applies, or would have applied to any such loss except for the existence of this insur- C. Increased Hazards: The policy condition suspending this insurance ance, the limit of liability of each type of insurance for such loss, hereby while the hazard is increased is hereby waived. designated as "joint loss," shall first be determined as if it were the only D. Vacancy and Unoccupancy: Permission granted for vacancy or nn- insurance,and this type of insurance shall be liable for no greater proportion occupancy without limit of time except as to loss excluded by Section II, of joint loss than the limit of its liability for such loss bears to the sum of paragraphs H and I and except as provided in any endorsement attached to all such limits. The liability of this Company (under this form) for such this policy. A building in process of construction shall not be deemed vacant, joint loss shall be limited to its Proportionate part of the aggregate limit of E. Description of Property: This insurance shall not be prejudiced if this and all other insurance of the same type. The words "Joint loss," as any error is made in describing the location of the property covered here- used in the foregoing, mean that portion of the loss in excess of the highest under. deductible, if any, to which this form and other types of insurance above F. Subrogation: This insurance shall not be invalidated should the In- referred to both apply. sured waive in writing prior to a loss any or all right of recovery against I{. Mortgagee Clause (This clause is void unless name of mortgagee any party for loss occurring to the property described herein. or trustee is inserted on the first pace of this policy in space provided G. Alterations and Repairs: Permission granted to make alterations, under this caption)—Lose, if any on the item(s) subject to this clause as additions and repairs, and to complete structures in course of construction. specified on the first page of this policy, shall be payable to the mortgagee In the event of loss hereunder, the Insured is permitted to make reasonable (or trustee) as provided herein, as interest may appear, and this insurance, repairs, temporary or permanent, provided such repairs are confined solely as to the interest of the mortgagee (or trustee) only therein, shall not be to the protection of the property from further damage, and provided further invalidated by any act or neglect of the mortgagor or owner of the within that the Insured shall keep an accurate record of such repair expenditures. described property, nor by any foreclosure or other proeeeding0 or notice of The coat of any such repairs directly attributable to damage by any peril sale relating to the property, nor by any change in the title or ownership insured against shall be included in determining the amount of loss here- of the property, or by the occupation of the premises Yor purposes more under. Nothing herein contained is intended to modify the policy require- hazardous than are permitted by this policy: Provided, That in case the menta applicable in case loss occurs, and in particular the requirement that mortgagor or owner shall neglect to pay any Premium due under this policy, in case loss occurs the Insured shall protect the property from farther dam- the mortgagee (or trustee) shall, on demand, pay the same. 8$e, Provided also, That the mortgagee (or trustee) shall notify this Com- H. Liberalization Clause: If during the period that insurance is in pany of any change of ownership or occupancy or increase of hazard, which force under this policy, or within 46 days prior to the inception date thereof, shall come to the knowledge of said mortgagee (or trustee) and, unless Per- on behalf of this Company there be filed with and approved oraccepted by mitted by this policy, it shall be noted thereon, and the mortgagee (or the insurance supervisory authorities, in conformity with law, any forms, trustee) shall, on demand pay the premium for such increased hazard for endorsements, rules or regulations by which this form of insurance could be the term of the use thereof; otherwise, this policy shall be null and void. extended or broadened, without additional premium charge, by endorsement This Company reserves the right to cancel this policy at any time as or substitution of form,then such extended or broadened insurance shall inure provided by its terms, but, in such case this policy shall continue in force to the benefit of the Insured hereunder as though such endorsement or sub- for the benefit only of the mortgagee (or trustee) for ten days after notice stitution of form had been made. to the mortgagee (or trustee) of such cancellation, and shall then cease, I. Minimum Retained Premium: It is hereby stipulated that if this and this Company shall have the right, on lace notice, to cancel this agree. policy is cancelled at the request of the Insured, the premium retained by ment. the Company will not be less than $7.60. This stipulation shall apply sepa- Whenever this Company shall pay the mortgagee (or trustee) any sum rately to each installment of Premium Payment Plan Policies and to each for loss under this policy and shall claim that, as to the mortgagor or renewal of Annual Renewal Plan Policies. owners, no liability therefor existed, this Company shall, to the extent of J. Apportionment Clause: This Company shall not be liable for a such payment, be thereupon legally subrogated to all the rights of the party greater proportion of any loss less the amount of deductible, if any, from to whom such payment shall be made, under all securities held as collateral any peril or perils included in this form than (1) the amount of insurance to the mortgage debt, or may at its option pay to the mortgagee (or trustee) under this policy bears to the whole amount of fire insurance covering the the whole principal due or to grow due on the mortgage with interest, and property, or which would have covered the property except for the existence shall thereupon receive a full assignment and transfer of the mortgage and of this insurance, whether collectible or not, and whether or not such other of all such other securities; but no subrogation shall impair the right of fire insurance covers against the additional peril or perils insured here- the mortgagee (or trustee) to recover the full amount of his, her or their under; (2) nor for a greater proportion of any loss less the amount of claim. (248-F6) 41 This memorandum is for information only; it is not a contract of insurance but attests that a policy as numbered herein, and as it stands at the date of this certificate, has been issued by the Company. Said policy is subject to change by endorsement and to assignment and cancellation in accordance with its terms. THE LIVERPOOL.AND LONDON AND GLOBE INSIJBANCE COMPANY LIMITED Stock Company—Established 1836—Entered United States 1848 EXECUTIVE OFFICE: ISO WILLIAM STREET ���>/� cl _ NEW YORK 38,NEW YORK S NO.LKF 96 44 00 Insured's Name and Mailing Address F_ -1 George T. Penn and Mildred Graham Penn P. 0, Box 368 Hialeah, Florida L J 7-22-63 7-22-64 1 Inception (Mo. Day Yr.) Expiration (Mo. Day Yr.) Years 31 It Is important*at the written portions of all policies covering the same property read exactly alike. If they do not,they should be made uniform at once. INSURANCE IS PROVIDED AGAINST ONLY THOSE PERILS AND FOR ONLY THOSE COVERAGES INDICATED BELOW BY A PREMIUM CHARGE AND AGAINST OTHER PERILS AND FOR OTHER COVERAGES ONLY WHEN ENDORSED HEREON OR ADDED HERETO. PREMIUM PREMIUM IF PAID IN INSTALLMENTSENTER PERIL(S) Insured Against AMOUNT RATE I IF PAID IN FULL I AMOUNT DUE AT IAMOUNTDUEATEACHsUB-I and Coverage(s) Provided AT INCEPTION INCEPTION SEQUENTANNIVERSARY (Insert Name of Each) $ 26,000.00 $ $ 17.50 $ $ F I RE AND LIGHTNING xxxxxxx $ $ 104.00 $ $ EXTENDED COV E R A G E $ $ 23.40 $ $ Other Perils (Soec.Form $ $ $ $ 218-F6) TOTAL(S) $ 144.90 $ $ $ TOTAL PREMIUM FOR POLICY ON INSTALLMENT BASIS Amount Fire or Per Cent of DESCRIPTION AND LOCATION OF PROPERTY COVERED Item Wre and Extended Co-Insurance Show construction,t a of roof and occupancy of building(s) covered or No. Coverage, or Applicable containin the property covered. If occupied as a dwellin stae number of families. Other Peril B P Pe Y P B 1• - $26,000.00 On the one story masonry dwelling, under con- struction, situated: 540 N. E. 103rd Street, Miami Shores, Dade County, Florida. Legal: Lots 7 and 8, Block 93, Miami Shores Section 4 amended, Dade County, Florida Subjectto Form No(s). 248-F6 (2-60) ; 906-2; 25-F1 attached hereto. INSERT FORM NUMBER(S) AND EDITION DATE(S) Mortgage Clause: Subject to the provisions of the mortgage clause attached hereto, loss, if anyy on building items, shall be payabi Dade Federal Savings & Loan Association of Miami, 101 E, Fiagler Street, Miami, �Ftirida. INSERT NAME(S) OF MORTGAGEE(S) AND MAILING ADDRESS(ES) Countersignature Date 7/17/63 Agency at Miami., Florida MV7er Ad F� zier I urance Agency, Inc Agent IN CONSIDERATION OF THE PROVISIONS– STIPULATIONS HE EIN OR ADDED HERETO AND OF the premium above specified, this Company, for the term of years specified above from inception date shown above At Noon (Standard Time) to expiration date shown above At Noon (Standard Time) at location of property involved, to an amount not exceeding the amount(s) above specified, does insure the insured named above and legal representatives, to the extent of the actual cash value of the property at the time of loss, but not exceeding the amount which it would cost to repair or replace the property with material of like kind and quality within a reasonable time after such loss, without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law regulating construction or repair, and without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest of the insured, against all DIRECT LOSS BY FIRE, LIGHTNING AND BY REMOVAL FROM PREMISES ENDANGERED BY THE PERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy, or pro rata for five days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but not elsewhere. Assignment of this policy shall not be valid except with the written consent of this Company. This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy. L 12271C 1 Concealment, This entire policy shall be void if, whether 84 relating to the interests and obligations of such mortgagee may 2 fraud, before or after a loss, the insured has wil- 85 be added hereto by agreement in writing. 3 fully concealed or misrepresented any ma- 86 Pro rate liability. This Company shall not be liable for a greater 4 terial fact or circumstance concerning this insurance or the 87 proportion of any loss than the amount 5 subject thereof, or the interest of the insured therein, or in case 88 hereby insured shall bear to the whole insurance covering the 6 of any fraud or false swearing by the insured relating thereto. 89 property against the peril involved, whether collectible or not. 7 Uninsurable This policy shall not cover accounts, bills, 90 Requirements in The insured. shall 8 and currency, deeds, evidences of debt, money or q give immediate written 9 excepted property. securities; nor, unless specifically named 91 case loss occurs. notice to-this Company of any loss, protect 10 hereon in writing, bullion or manuscripts. 92 the property from further damage, forthwith 11 Perils not This Company shall not be liable for loss by 93 separate the damaged and undamaged personal property, put 12 included. fire or other perils insured against in this 94 it in the best possible order, furnish a complete inventory of 13 policy caused, directly or indirectly, by: (a) 95 the destroyed, damaged and undamaged property, showing in 14 enemy attack by armed forces, including action taken by mili- 96 detail quantities, costs, actual cash value and amount of loss 15 tary, naval or air forces in resisting an actual or an immediately 97 claimed; and within sixty days after the loss, unless such time 16 impending enemy attack; (b) invasion; (c) insurrection; (d) 98 is extended in writing by this Company, the insured shall render 17 rebellion; (e) revolution; (f) civil war; (g) usurped power; (h) 99 to this Company a proof of loss, signed and sworn to by the 18 order of any civil authority except acts of destruction at the time 100 insured, stating the knowledge and belief of the insured as to 19 of and for the purpose of preventing the spread of fire, provided 101 the following: the time and origin of the loss, the interest of the 20 that such fire did not originate from any of the perils excluded 102 insured and of all others in the property, the actual cash value of 21 by this policy; (i) neglect of the insured to use all reasonable 103 each item thereof and the amount of loss thereto, all encum- 22 means to save and preserve the property at and after a loss, or 104 brances thereon, all other contracts of insurance, whether valid 23 when the property is endangered by fire in neighboring prem- 105 or not, covering any of said property, any changes in the title, 24 ises; (j) nor shall this Company be liable for loss by theft. 106 use, occupation, location, possession or exposures of said prop- 25 Other Insurance. Other .insurance may be prohibited or the 107 erty since the issuing of this policy, by whom and for what 26 amount of insurance may be limited by en- 108 purpose any building herein described and the several parts 27 dorsement attached hereto. 109 thereof were occupied at the time of loss and whether or not it 28 Conditions suspending or restricting insurance. Unless other- 110 then stood on leased ground, and shall furnish a copy of all the 29 wise provided. in writing added hereto this Company shall not 111 descriptions and schedules in all policies and, if required,verified 30 be liable for loss occurring 112 plans and specifications of any building, fixtures or machinery 31 (a) while the hazard is increased by any means within the con- 113 destroyed or damaged. The insured, as often as may be reason- 32 trol or knowledge of the insured; or 114 ably required, shall exhibit to any person designated by this 33 (b) while a described building, whether intended for occupancy 115 Company all that remains of any property herein described, and 34 by owner or tenant, is vacant or unoccupied beyond a period of 116 submit to examinations under oath by any person named by this 35 sixty consecutive days; or 117 Company, and subscribe the same; and, as often as may be 36 (c) as a result of explosion or riot, unless fire ensue, and in 118 reasonably required, shall produce for examination all books of 37 that event for loss by fire only. 119 account, bills, invoices and other vouchers, or certified copies 38 Other perils Any other peril to be insured against or sub- 120 thereof if originals be lost, at such reasonable time and place as 39 or subjects. ject of insurance to be covered in this policy 121 may be designated by this Company or its representative, and 40 shall be by endorsement in writing hereon or 122,shall permit extracts and copies thereof to be made. 41 added hereto. 123 Appraisal. In case the insured and this Company shall 42 Added provisions. The extent of the application of insurance 124 fail to agree as to the actual cash value or 43 under this policy and of the contribution to 125 the amount of loss, then, on the written demand of either, each 44 be made by this Company in case of loss, and any other pro- 126 shall select a competent and disinterested appraiser and notify 45 vision or agreement not inconsistent with the provisions of this 127 the other of the appraiser selected within twenty days of such 46 policy, may be provided for in writing added hereto,but no pro- 128 demand. The appraisers shall first select a competent and dis- 47 vision may be waived except such as by the terms of this policy 129 interested umpire; and failing for fifteen days to agree upon 48 is subject to change. 130 such umpire, then, on request of the insured or this Company, 49 Waiver No permission affecting this insurance shall 131 such umpire shall be selected by a judge of a court of record in 50 provisions. exist, or waiver of any provision be valid, 132 the state in which the property covered is located. The ap- 51 unless granted herein or expressed in writing 133 praisers shall then appraise the loss, stating separately actual 52 added hereto. No provision, stipulation or forfeiture shall be 134 cash value and loss to each item; and, failing to agree, shall 53 held to be waived by any requirement or proceeding on the part 135 submit their differences, only, to the umpire. An award in writ- 54 of this Company relating to appraisal or to any examination 136 ing, so itemized, of any two when filed with this Company shall 55 provided for herein. 137 determine the amount of actual cash value and loss. Each 56 Cancellation This policy shall be cancelled at any time 138 appraiser shall be paid by the party selecting him and the ex- 57 of policy. at the request of the insured, in which case 139 penses of appraisal and umpire shall be paid by the parties 58 this Company shall, upon demand and sur- 140 equally. 59 render of this policy, refund the excess of paid premium above 141 Company's It shall be optional with this Company to 60 the customary short rates for the expired time. This pol- 142 options. take all, or any part, of the property at the 61 icy may be cancelled at any time by this Company by giving 143 agreed or appraised value, and also to re- 62 to the insured a five days' written notice of cancellation with 144 pair, rebuild or replace the property destroyed or damaged with 63 or without tender of the excess of paid premium above the pro 145 other of like kind and quality within a reasonable time, on giv- 64 rata premium for the expired time, which excess, if not ten- 146 ing notice of its intention so to do within thirty days after the 65 dered, shall be refunded on demand. Notice of cancellation shall 147 receipt of the proof of loss herein required. 66 state that said excess premium (if not tendered) will be re- 148 Abandonment. There can be no abandonment to this Com- 67 funded on demand. 149 pany of any property. 68 Mortgagee If loss hereunder is made payable, in whole 150 When loss The amount of loss for which this Company 69 interests and or in part, to a designated mortgagee not 151 payable. may be liable shall be payable sixty days 70 obligations. named herein as the insured, such interest in 152 after proof of loss, as herein provided, is 71 this policy may be cancelled by giving to such 153 received by this Company and ascertainment of the loss is made 72 mortgagee a ten days' written notice of can- 154 either by agreement between the insured and this Company ex- 73 cellation. 155 pressed in writing or by the filing with this Company of an 74 If the insured fails to render proof of loss such mortgagee, upon 156 award as herein provided. 75 notice, shall render proof of loss in the form herein specified 157 Suit. No suit or action on this policy for the recov- 76 within sixty (60) days thereafter and shall be subject to the pro- 158 ery of any claim shall be sustainable in any 77 visions hereof relating to appraisal and time of payment and of 159 court of law or equity unless all the requirements of this policy 78 bringing suit. If this Company shall claim that no liability ex- 160 shall have been complied with, and unless commenced within 79 isted as to the mortgagor or owner, it shall, to the extent of pay- 161 twelve months next after inception of the loss. 80 ment of loss to the mortgagee, be subrogated to all the mort- 162 Subrogation. This Company may require from the insured 81 gagee's rights of recovery, but without impairing mortgagee's 163 an assignment of all right of recovery against 82 right to sue; or it may pay off the mortgage debt and require 164 any party for loss to the extent that payment therefor is made 83 an assignment thereof and of the mortgage. Other provisions 165 by this Company. 41 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. DateZ 3 --- -- ,19.. Owner's Name and Address.-- _----------- I�P,—Y I-----� r NtY ---•---- No.�w28 ------- Street....UJ. �l_5t i o�ea L Registered Architect and/or Engineer---.--_________________._____G�ra�--__. � Name and address of licensedcontractor___ _ $_ ___ �.a.`r`.a�-_� ____________________________ ----------------- ----------- ------------ Location and legal description of lot to be built on: Lot----------------�-1'---�------------ Block-- --------------�.,? _ CT� N �Wlt ud�vJ Subdivision Street and Number where work is to be done-----------------J�_ v----- I -S State work to be done andS purpose of building (by floors)------------------�---=�'�.�?��----------------------------•--•---- t S�CXlw�9------------- ---------------------------------------------...------------------------------------------------------------------------------------------------------------------•-----"---------------_-•-----••--- '----_-------------- ---- -•------------------•-----------------•------------------------"-----------------------------—------ ------------------------------------- ----------------------------------------.and for no other purpose. New Building--------------______------.. Remodeling----------- --------- Addition---- ------------------ Repairs----•------------------- No. of Stories.------2-==:_----- To be constructed of-----0-3 .. q-------- Kind of foundation---------- ?Q-"v�----.. _- }_`.._ ___ Roof Coverin �p _-_ ..._ g-.----_.---�-r J 7 OS l)V Estimated Total cost of improvements $---------.`�.___��__._____.•_________________Amount of Permit $. .7 t A j, Zone cubage required -•- W C7 ------------------------------------_--Plan Cubage-__4 4,J 0 1k -� 'y"�Y �(�i-------- Distance ---Distance to next nearest building___________________________________________________________Size of Building Lot--------------------I.;L x----- --,--------- Maximum live load to be home by each floor--------------------------------------'--------------------------------------- ------------------------------------------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may 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 subcon c err on work to be p��ed under this permit, as are licensed by Miami Shores Village. Remarks---------------— ------------------------------------ - (Signed)---------- ------ - -- - - - � -----------_---------- ---- STATE OF FLORIDA, I COUNTY OF DADE. I ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ------------------------------------------------------------------------------------------•---------------------- •---------------------------'--------------------------------------------------------------------------------------------------...------------------------•----------------- -----'to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_--________________-.__-._______--_______._._._________ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tZL 10Zrue.j Permit No------- _�f--------.________ Date.____.,t _=__ _ __.__-_(:T_ Read,Sworn to and Subscribed before me. Disapproved ----------- ---- ---- Date- ----------- ---------------------- -------------- -------- Notary Public,State of Florida (Signed) ::7 - - -- ---- ------------ ----------"--------'- Bu ding Inspector My Commission Expires.___________________________________________________________________ PLANNING BOARD----------------------------------------------------DATE Chairman ........------------------------------------------------------------------------------------- Member ---------------------------------- - Member ------------------------------------------------------------------------------------------------ Member --------------------------------------------------------- Member .___ ------------------------------------------------------------------------------------ Member CouncilApproved------------------------------------------------------------------------Date Disapproved --------------------------------------------------------------- -----..Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. 0 72- 0 71 �� 174 j 15 -0 0100 It C:, X01, TO A X /0 0 00, L'70 THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUSPLACE A PENALTY IS IMPOSED FOR FAILURE TO KEEP THIS LICENSE EXHIBITED AT YOUR ESTABLISHMENT OR PL�CE OF BUSINESS a��t,,Q �a 193 r Village ense y THIS LICENSE EXPIRES na4e 304 19 N° 6451 In consideration of the sum of 6sr i jnnp Dollars ($ ) Paid to Miami Shores Village, Dade County, State of Florida, '9 is hereby licensed to engage in or operate the business of (uw MIAMI SHORES VILLAGE;.-:4 FLORIDA Date Issued By < ' v� THIS LICENSE NOT TRANSFERABLE WITHOUT THE APPROVAL OF THE VILLAGE MANAGER. M9V/1991 - -- APC9 Waaml Shores Village APPLICATION FOR FINAL INSPECTION Prior to a final inspection this application must be filled out; if sub contractors have failed to take out permits the general contractor shall be responsible for the permit and fee. A final 1%,3pection must be made prior to the release to Florida Power and Light Co. and the issueance of a certificate of occupancy. OWNER JOB ADDRESS ® �y 0X X. /103 = Y . LOT BLOCK SUB. BUILDER �A.,R� DAY LABOR CONTRACT DATE ,� /4' 194'3 .. - ITEMS SUB COONCSTSJPPLIIIZS AMCONTRACTORS &ADDREANPUNT �1. Architectural Fee lens r- 1-0..4.td _°v, 049S v �,- As halt walks drives etc. d� - ,�3. Cabinets - Bath Vanity P4. Cabinets - Kitchen - 4,4 6. �• = �, ou v 5. Cabinets --Medicine TrA r 44en go�' A,e.p , Q ,-6. Cabinets - Unit Closet v7. leanin ,�- a cb a -8. Clearing Site P9. Concrete - Foundation labs Beams D ; "10. Concrete - Walks drives etc. 11. Contractors Fee 1-12. Electric Fixtures ,13. Electric Wiring_ �� z� �j� 5- n k14. EquilMent Rental 04 e XA .15. Excavation 16. Pill for S1 ..b r=e-&- 75' D r17. Floors - Famish wood & kitchen 'A.�T-C s ,+r,, _g",-- /L"', Ofto1?® 4Q a8. Floors m Terrazzo i2 .- cy-. H 1,4LA4 14 !r -b v19. Gare F: cors dV eA".e_,d Od=mci mayrE 2-S P 20. Glass �Sliding Doors a 21. Hardware - Finish X22. Hardware - Rough 1,rr, X23. Heating �- �,_ o�L Fs'ia,� 7-d a-0 ; 24. Insurance - Liabili co .®bond a.%S &A _ e e � S-®• a'a ,25. Labor - Pa ol1 �,� c,* 4a® y67 Labor - Contract 2 7. Labor - Contract v28. LandscUing, Fill Grading, �' ,=mss.` Cdvo d , �-r. S� A:!a 1/29. Lath Plaster Stucco XZ: arm bo ,30. Lumber All s C2�,l. P31. sonry Labor -2 Ea� .32. Ra-sonry Materials, Block /,� r33.M11work x-34. Miscellaneous 35. Ornamental Iron Work E� ,.36. Oven & Plate - Built-in o ,,�. ��, ,�,�, 75; 6 4% Y37. Overhead ---v38. Parotin s s--QL,e®LI.. 701q,06 A9. Permits T2Moraa Power ga Zcrn<c . X40. ilia Foundation v41. Plumbing Com lete v�Led_ ° P142, Pool - Swimming �-� -----r43. Roofing & Sheet Metal Work ,c a��,� l�z.•. a ®® -44. Roof Trusses - Pre-fab. z v� 45. Screen Enclosures ,46.. Se tic Tank or Sewerage A�+,v� �� .•nz- elK sk PioI TO 6 0 X47. S ower or Tub Enclosures c���¢� zu�, . _ ®. g v48. Steel - Reinforcing & strl. , L , _ ,�, Z �. t,49. Su ervision -_---v,50. Surve s �rrp- ®•: -51. Tile & Marble v52. Water - Public d53. Water - Well & Pum -54. Windows - Glazing & Screens C .¢ 2 A A. a v® X55. Window Frames - Concrete A.-•.4k ,��, Al 770, Go SIGM TOTAL . ..;:. ANNUAL RENEWAL PLAN ENDORSEMENT Florida (Edition 8-67) In consideration of the premium, and the stipulations, terms and conditions of the policy to which this endorsement is attached, it is agreed that the Insured shall have the option to renew this policy annually for four (4) successive years, by the payment of a premium calculated at ninety per cent (909o') of the rate(.$) at which the policy was originally issued or subse- quently endorsed, but in no event less than the minimum premium applicable; provided each such renewal shall be evidenced by the issuance,of a properly countersigned renewal certificate, and that each such option to renew be exercised not later than the expiration dtte of the policy or of the renewal certificate last issued. No insurance shall exist hereunder beyond the expiration date of this policy or the expiration date of the renewal certificate last issued. Nothing in this endorsement shall be construed to waive any of the provisions of the policy to which this endorsement is attached or the cancellation privilege of either the Insured or this Company. -.Amon NOW i VILE ws WINDSTORM EXTERIOR PAINT AND WATERPROOFING F a.-S-S. C. EXCLUSION CLAUSE Fl . C. (Edition 10-62) It is hereby stipulated that coverage under this policy does not include damage caused in any manner by windstorm to paint or waterproofing material applied to the exterior of the building(s) or strueture(s) covered hereunder. The value of paint or waterproofing material, being excluded from the coverage as above stated, shall not be considered in the determination of actual cash value when applying the Co-Insurance Clause appli- cable to loss from windstorm. K .ii\\ f5f �. MIAMI SHORES VILLAGE l PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT �- f Date -9/13/67-- 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. Ownee s Name and Address------MARTNF2L _—_ No.—. __ _ Street-.......--........................-......... Registered Architect and/or Engineer- VIGKERS UT41 TrT Employing Plumber's Name-------_._ _ _ No. Stree ---------_--- -Location and Legal Description Lot-_- B Subdivision-...___ ----- Streeet and Number where work is to be perform -No- 549 N 9 i tomStreet._._.-.-.-.-..._.._-_------------ State work to be performed and purpose of building y � � _� ___---_--_._--•_----•-----.-_---_--•-----_---...__---_-_-_ New Building-----____._.-_._._. Addition-__--__.. Repairs.__------------------- No. of Stories._....................... CLOSETS BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL TUBS SHOWERS TORIES SINKS SINKS TUBS RINALS BASIN DRAIN FOUNT'NS FIXTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SW1M'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM P004 CONTR. LIST 1 CHECK 1 Size Septic Tank-_._.._-___------_ ----- Type Of Tank---- ------.--------Capacity Gals.....-......-..........-....... ----------- Feet of Drain Feet of Tank or Drain Field from Well........_ _ _._._..------------.__.._--- ... ................ Nature of Water Supply: City-Well.-____-__._____ -----Size of Soakage Pit........._..........�____._____ 211 TRR RUPT)T7 T ML,j, Amount of Permit � �_ _ � (Signed)--L, ---_- .. -------------- - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of labor under the Florida Workmen's Compensation Act,being Section 5988,Compiled General Laws of Florida Permanent Supplement, and lids 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 wor t be Vorned under this permit, as are Beene d by MiamiSham Village. (Signed)— -------•-----------_.._..___....._..-----------•-- Master Plumber. STATE OF FLORIDA, g COUNTY OF DADE. j Before me,the undersigned authority,a notary public,duly authorized to administer oaths and take acknowledgments, personally appeared to me well known,and who,being by me first duly sworn,upon oath deposes and says that he is the_--_.......-......_........_.._...------------------------- otheabovby e described construction, that he has carefully read the ffooregoing application, and that he did sign the same, and that all facts ted 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•neoessary by improper notice for inspection, or faulty materials and/or worl®anship. MIAMI SHORES VILLAGE 70 1525 30 $4.00 PLUMBING INSPECTION DEPARTMENT �y APPUCATION FOR PLUMBING PERMIT Permit N._1 -?�� , Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described.This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida,all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with,whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address-----_ No. 540 —___ Street..---N_-103 Street Registered Architect and/or Engineer— Employing Plumber's Name-den-les Cis SvcStem _-- No..— 564 _-- Street NE 125 Street Location and Legal Description Lot Block —__.__. Subdivision- _ __— Street and Number where work is to be performed—No. —---------- —.. State work to be performeS and purpose of building (By Floors)____------___ —_— :----_---___.__._.----_--------_-.-_-_--._.-___--_ --__--- New Building_____--______._-_____Remodeling—__—Addition_____..___—____. Repairs-------_.____-------- No. of Stories..__-_..... ___....... BATH LAVASLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS FIXTURES CONm LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL COMTR. LIST CHECK Size Septic Tank_---------. ------.---Type of Tank—_ —- - —— — -.----------Capacity Gals_--------------------------- Feet of Drain Tile_ ---------____ __ - Feet of Tank or Drain Field from Well-_---------.------------- ---_----------- Nature of Water Supply: City—Well__--__---- __ -Size of Soakage Pit------------------------------- --------- Gem Gul - ------- ---- Amount of Permit -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ations as an employer of labor under the Florida Workmen's Compensation Act,being Section 5988,Compiled General Laws of Florida Pe ent 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 Acct. 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) Af OZ2�................................ Master Plumber. STATE OF FLORIDA, } 88. 6r COUNTY OF DADE. Before me,the undersigned authority,a notary public,duly authorized to administer oaths and take acknowledgments, personally appeared to me well known,and who,being by me first duly sworn,upon oath deposes and says that he is the.------.-_. -----_ --. ------------------. ...-_-. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public,State of Florida NOTE: A re-inspection fee of $1.00 will be made when so&minspeetion is made necessary by improper notice for Insp. ' n, or faulty materials and/or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby inade for the approval of the detailed statement of the plans and specifications herewith submitted for the build- in¢ or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be comphQ with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date..._..._... � ' .3»»_.._. .__..,192-: •- Ow-ner s Name and Address... :. .c..........1. . ..P :. ..........._...................»»»..._ No. » ........ Street.»��.. .�l1 ».1� :. > RegisteredArchitect and/or $pgincer............ .................................................................n:,..,..,K..•.,,..,,.,..:,,.,,r.•m.:... «,,,.,....................I.......... Name and address of licensed contactor.... Location and legal description of lot to be built on: Lot............................................ Block.................................. Subdivision.--.._.............__.»_... .» .» _....._._..._....-----..............._..._._ Street and Number where work is to be done..._.." State work to be done and purpose of building b floors ...._N_ .................�...._......._.__....».»...».»..................___......_..... _.......................•--.........._-----•----............................--.._.-__.---_-._--_-..............._-•--••-•---.._........__..___...__._. __....aad for no other purpose. New Building............................. Remodeling................. ........ Addition.......................... Repairs.......................... No. of Stories..............»...... _ To be constructed Kind of foundation.............................................................— Roof Covering..................................... _..._ Estimated Total cost of improvements $.............................. ...............Amount of Permit $......._.-..--_-_................ Zone cubage required............................................ _ _...31an Cubage..................._.___.__..._..._......... Distance to next nearest building........................................................Size of Building Lot........-_........_....._._-......_........... ....___ Maximum live load to be borne by each floor--•........................—.--•-•-••.--------....---................-----.....-_--...._._....--•......._......................... .. . I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966,Compiled General Laws of Florida,Permanent Sup dement, and has complied w-itl: 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 insp tion on the site of the work such public notice or notices as are required by the Act.The undersigned agrees to employ only such suet o7_4 k to be performed under this permit, as are licensed by Miami Shores Village. Remarks------------••-•-•------•---•--••--—__- -- __ (Signed)�__�_»� .. ._. - STATE OF FLORIDA, ` COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public,duly authorized to administer oaths and take acknowledgments, persortally ap- peared -----------------•-_--•----•--•---•-------•-----_-------...._._-.---•----- - —-----.-----------------------------------------.---.-.--- ---_...----.............._.- --------------•-------------•--------------- — -...—_ -- ........_........-..._._-__ _ _ ._ -- ----to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the................ ... ._...w.................._......_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same,and that all facts therein by him stated are true. J �+ ) Permit No._ ` --------- -Date......L_a—. Read,Sworn to and Subscribed before me. o a Disapproved D te--•------�- - - - - -�..�...— r Public,State of Florida (Signed) ......................-........ ....................... Building Inspector My Commission PLANNING BOARD-......_..........................._...._..__.-DATE Chairinan ......... ............................__......-.....-...-. __.._ __ __ Member .......—..................... _ ....._ .__._...... .— -__. Merr:ber ...... ___ Member __-._.... ._...__............._._.___..__......__.-..........._....__._ Member .. .... ...............-.....................__.. __._.- __._ __ -_..__ Member Council Approved......-....................................._.._-........__----Date Disapproved .._.....-......_............................................................Date NOTE: A ch.uge of $1.00 will be made for making corrections or changes to this application after approval has been obtained frrnn the I'lannin;{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. TELEPHONE 787-1210 I OF LEESBURG n+e weruos U. S. HIGHWAYS 27 & 441 LEESBURG, FLORIDA 32748 a X � a 'k 9 MIAMI SH RES 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 Shares Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date---------- �_ 19-�`.. Owners Name and Address----- -------_ -------r_F 1 j------- ----- No c� - Street_1 L=- �j RegisteredArchitect and/or Engineer----------------------------------------------------------•---------------------------------------------- --------------------------•---•------------------------- L71311� `�`tt °I ------_ !. c9yr S--I�F4dAii,- Name and address of licensed contractor----------------__- _-- ___-- _ ` . Location and legal description of lot to be built on: Lot_--- _-Y�--2....---------- Block_ U - --- Subdivision-4*23_I_t5_1_!_!-------51 Street and Number where work is to be done----------------- -•_-_ _----_---------__-�_ State work to be done and purpose of building (by _ 5� ? '2�__ '__-__ -- ------- ---- -------------------------- -------------------------------------------------------------------and for no other purpose. New Building--_---------------------. Remodeling---------- ------ Addition-------------------------- Repairs-.------------------------ No. of Stories........__•----.-----_- To be constructed of---C.8&t.la_ d1_%Kind of foundation------------------ ------------------------__ Roof Covering--------------.-- !21�.,e------------ Estimated Total cost of improvements $----------.__1_^` ----------------Amount of Permit $--------1c-_��------------------------•--------------------------------- Zone tubage required------------------------------------- ----------------------------Flan 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 rovisions thereof, and will require similar compliance from all contractors or sub-contractors em F,,-)Iic d by him in the work to be performe�under this permit; and will post or cause to be posted for inspection on a site of the work notice or notices as are required by the Act.The undersigned agrees to employ only such subcontract work to be rfo nder this permit, as are licensed by Miami Shores Village. Remarks----_----------------------- ----------------- - --— —_—_ (Signed)----- - � STATE OF FLORIDA, -�— COUNTY OF DADE. I ss' Before me, the undersigned authority,a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - -- - ------------------------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------_---to me well known, and who,being by me first duly sworn, upon oath deposes and says that he is the_--------- --------------_-----------_------- ---------_-------_--------.._ __ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.� a__�®____�__- D L./p --____r" Read,Sworn to and Subscribed before me. - -- a - ------- ------------- Disapproved -- — ------------- ------------------- -- ----- --- -• No Public,State of Florida (Signed) - --------------- --------------- --------- ---- --------- Buildmg Inspector My Commission Expires_________________________ PLANNI OARD------------------- - -------------------------DATE Chairman ---------------------------------------------------------------------------- Member ------------------------------------------------------------- Member ------------------ - ----- - ------------------------------------------- Member ---------------------------------------------------------------- Member ----------------- ------------------------ — -- ------------__ Member --------------------- Council Approved.-_---- ---------------------------------------------_----------Date Disapproved __ -_-----Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHORES VILLAGE, FLA. NO 5340 ' ]oB ADDRESS INSPECTION '� � TIME REMARKS: INSPECTOR_ DATE . m 1 ERTIFICATE OF OCCUPANCY i MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N° 1486 12-17-63 Miami Shores Village, Florida, ' GEORGE T_. PENN Oy r, Agent or Tenant of Building L 7 8 _ Block 93 Subdivision - Shores Sect. 4 S et Address 540 N. E. 103rd St. Approved use by occupancy bedroom, bath residence Remarks: 4350 This Certificate of Occupancy is issued to the above named OWner for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. PLAN CUBE 29,026 �� TAX VALUE 14 513 BUILDING DIVISION 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. ss // Date-- -�--�--•-----�--���---------------------------�--.,19Ga_�1 Owner's Name and Address-------- --a_�_Y.gjl'------—-------------------- �i0 ��_ Street- — No. `� Registered Architect and/or Engineer-----------------------------— - --- -- - -- - - Name and address of licensed contractor- e� ��� - ------JF_1���_'_---�1�_C' --------------------------------------- Location and legal description of lot to be built on: Lot------------------------ Block----------------- Sub/dii* 'on- -- - -- - - -- - Street and Number where work is to be done_-_ � l'�' ✓Z- ' Y'----- ------------- - --------------------------- State work to be done andp ose f building (by fl7r�ss)- ----------------------------------------------------------------------------------- - -------------------------------___----and for no other purpose. New Building---------------------------- Remodeling------------------—_ Addition----------------------- Repairs-------------------------- No. of Stories-------------------------- To be constructed of---------------------__ Kind of foundation----------------------------------------------- Roof Coving----------------------------------------------- Estimated Total cost of improvements -z� P $---���=--�2 � _Amount of Permit $----------------�=-`5----------------------------------------- Zone tubage 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 5988,Compiled General Laws of Florida,Permanent Suplenient, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employeTby 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 tractors, on work to a performeunder this permit, as are licensed by Miami Shores Village. Remarks---------------- ---— — (Signed)-- -�°��— ��!��� STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ---- -— - ---- - ---------- ------- -- ---- - -___—- - —— -----to me 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 tru . Permit No.-- ____:______ Date1� �&0- ______— Read,Sworn to and Subscribed before me. Disapproved _____—_—____----------_____ Date_ ------ -------------------------------------------------------------- (Signed) --- -------------- -- /I� -- Notary Public,State of Florida �'�=----=--�--- — -- - ' Building ector �"�� � — My Commission Expires------------------------------------ PLANNING 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 $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. �J !� L� J C� a .� �C — — - - .— — � � � _ �� � � � -� � � � � � � � � � � \ 5. �w _ --.._ ---.._...____— � � � � �' / � \ � / � �" � � ' � � , � r 1 f � \/i � / til . C � Q3 �� ��- rOWNER'S NAME PRESENT ADDRESS I LICENSE NO. I PHONE NO. Gro�4 P � . I (oZ 8 & `l- 'S+ N►h ev L bfl OB LOCATION (ST.OR AVE.) LOT BLOCK SUBDIVISION t Sod N. I". X03 °=° S{-. 1 74 8 I 13 I A • shoe-ts Je�'f X GENERAL CONTRACTOR I ADDRESS I PHONE NO. I LICENSE NO. BUILDER'S BOND BUILDING PERMIT NO. 3 9 cb I DATE 7-z3-` I PERMIT FEE$ 7 8 I NO. '2124 DATE 7 573 ZONE /��p REQUIREMENTS / 100 CU.FT. PLAN CUBE Zr CZ�. CU'FT. EST.COST$ Qs� DATE DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY:�+• H• l JgfL(l-lEC.. NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTIONINTERIOR CONSTRUCTION C83 lab- o I T��c I �itdronr,. 3 go.f4 2tsiC/c.,cc DESCRIPTION REPAIRS �4lyd�LO -�aa/3� G54/L.( &-J CQ.l�lv�n �a�� L4S@ c,-1 ALTERATION DESCRIPTION ADDITION 4,, ,- SUBMITTED TO PLANNING BOARD I APPROVED I REJECTED I REFERRED TO COUNCILI REASONS RE-SUBMITTED TO PLANNING BOARD I I I I I I SUBMITTFO TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. IJ x/ I ISSUED/2--/7-401 BY I TO BUILDING PERMIT AND INSPECTION RECORD—MIAMI SHORES VILLAGE--' BUILDING INSPECTIONS 4SU-7 INSPECTIONS DATE BY INSPECTIONS I DATE BY FOUNDATION I ROOF BEAMS& LINTELS I I POOL FRAMING I AIR COND. FINAL CLEAN UP SLAB SLAB PLUMBINGPERMITS & INSPECTIONS � CONTRACTOR b 66S T `p/, ^va 4,¢ PHONE PERMIT NO. c � I DATE `t- row I FEE$ 3� NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIALS PERMITS PERMIT NO. I DATE I FEE TEMPORARY SERVICE I I Is SEPTIC TANK eV �'�'F�i� - a � Is SEWER I is SOLAR HEATER I is GAS I is IS INSPECTIONS DATE I BY RE-INSPECT BY RE-INSPECT BY ROUGHING TUB&TOP OUT SEWER SEPTIC TANK SOLAR HEATER FIXTURES M GAS ��'�<•'/e, S ELECTRICAL 1PERMITS & INSPECTIONS �} CONTRACTOR (9l a,-rbc- PHONE PERMIT NO. 4+4-1 I DATE FEE S 131 NEW BLDG. ✓ I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S 9 H.W. HEATER CONN. S �+. RANGE CONN. S MOTORS I S FIXTURES I I S S sl INSPECTIONS I DATE BY RE-INSPECTI BY RE-INSPECT BY TFMP. SERVICE I I I ROUGHING H.W. HFATER CONN G RANGE CONN. 1 R I FIXTURES&FINAL l- APPROVAL TO POWER CO.FOR SERVICE DATE BY MIAMI SHORES VILLAGE il PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ftra 0 Nad..-.---.------ Application is hereby Iw.de for the approval of the detailed statement of the plans and specifications herewith submitted fof the building or.other structure herein described.This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida,all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with,whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. �-- Owners Name and Address__—__- Street___!�> �!F _--- Registered Architect and/or Engineer _ Employing Plumber's Name-_---!___��' 5 Co ��ig I��''� No. 2; _ y Iioscatioa and-Legal Description Lot Block Subdivision-____....________— -_-- Street and Number where work is to be performed—No '-'--' eZ," State work to be performed and purpose of building (By Floors) _— _------.__._.------_•-------__----------_--------....... New Budding_------_---- Remodeling Addition---------_ Repairs_--_-_---_--___.. No. of Stories__---------___ BATHLAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSCfs TUBS SHOWERS TORIES SINKS SINKS TUBE URINALS BASIN DRAIN FOUNT.NS �- FIXTURES LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE' SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL I` CONTR. LIa9' CHECK Size Septic Tank--------..- --- -Type of Tank -------------____--_._____---Capacity Gals.............................. Feet of Drain Tile_— _____—___� —Dist. Feet of Tank or Drain Field from Well___—_—_ ___.----_----------.--. .__ _._._.................. Nature of Water Supply: City—Wall—_ --.__ ._._.—____--Size of Soakage Pit—------_--___ _--_-------___.- Amount of Permit $_ -_. (Signed)— F _ --------- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obh as an employer of labor under the Florida Workmen's Compensation Act,being Section 5988,Compiled General Laws of Florida Perman Supplement, and has com- plied with the provisions thereof,and will require similar compliance from all contractors or sub-contractors em yed 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 un s pas are licrosed by Miami Shores Village. , I (Signed)— STATE Signed)STATE OF FLORIDA, l � COUNTY OF DADE. j Before me,the undersigned authority,a notary public,duly authorized to administer oaths and take acknowledgments, personally appeared to me well known,and who,being by me first duly sworn,upon oath deposes and says that he is the____.-------—------------------------—._._.__-_-_.---_ ------- of theglove described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts amain 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 worlinanship. �YWENNEW t 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.---- -1//../ 1 3-- -------- --•------,19........ Owner's Name and Address.... . f /I�lI L..------------------------... -----------•----- No.vY®---------- Street-- - Registered Architect and/or Engineer.__-__----------------.i---------- Name and address of licensed contractor_._,,.,2_L_ Location and legal description of lot to be built on: Lot---------------------------------------.- Block--------___------------------ Subdivision----------------------------------------------------------------------------•----- Street and Number where work is to be done--------6-# ----- - ---(--®. - State ork to beet a purpose of building b floors _____________ ________ __�____________._________.----------------------------------------JoS ,�// P rP g ( Y ) ........ -----------------•---•-----------------------------------------------------------------------------------------------------------------------------------------------------------------------.and for no other purpose. New Building_..._.---------------- Remodeling----------_---.-------- Addition-------------------------- Repairs----------.--------------- No. of Sues - _ _ ._ ------------------- To be constructed of.------- ----------. ._ _ Kind f foundation-----------------------------------------_-- -------------- Roof Ging-_--__- -._.---' Estimated Total cost of improvements $.-- --[� _B_-_______________________Amount of Permit $------6------______ __-_________--______________-_____-- Zone cubage required------------------------------------------------------------------------------Plan Cubage------------------ Distance to next nearest building_--------------------------------------------------------Size of Building Lot--------------------------------------------------------- -----------------._.. Maximum live load to be home by each floor---------------------------------------------------------------------------------------------------------------•------ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to---------------------------------------------------------------------------------------------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966,Compiled General Laws of Florida,Permanent Sup element, and has complied with the rovisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be pe forme 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 s ntractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks---------------------------------------------------------------------------------------- (Signed) '-y`' ' STATE OF FLORIDA, p COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ---------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------=--------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------—---------------to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_-----.._-----------------_-------------..-----------------._ of the above described construction, that he has carefully read the foregoing application, and that he did sign-the same, and that all facts therein by him stated are true. Permit No._---��--_ ________ Date..____ ___ _/�___ Read,Sworn to and Subscribed before me. Disapproved ---- — _ Date --- ---------------------------- -------------------- ----- ----- -------- -- --- --------------..................-......... Notary Public,State of Florida (Signed) (iidl!i!g -. -- ----- B Inspector My Commission Expires________________________________ __________________________ PLANNING BOARD---------------- ---------------------------------DATE Chairman ------- - ----------------------------------------------------------------------------- Member ----------------------------- Member ------------------•----------------------'---------------------------------------------------- Member ------------------------------------------------------••----------------- Member .. ---- ------------------------------------- ------------------------------------------ Member ------------------------------------------------------------------- - CouncilApproved-------------------------------------------------------------------------Date Disapproved --------------------------- '-..____-------------------- --------------Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHOR SVILLAGE BUILDING INSPECTIO EPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept a building during progress of the work. Date.-- 19..- - , _ Owner's Name and Address._..JA_;?_ � t"��� �� ---------- W G°I. No._.. Street Registered Architect and/or Engineer.------__--------------------------------------- .------------ -----------•------------------------ Name and address of licensed contractor._ .4 %OA izo---_______kl&-----------e 14aJTLOeelA__94A—__.,__--_.tom--:-__.�r�_�-_--a---_----___- Location and legal description of lot to be built on: ' a Lot------------ 15�----------- Block-----------13------------- Subdivision. 1 �_[-�,�ir��.� r c' - - Street and Number where work is to be done..... �______-_- ®_= _ ___.. ���r - -----•---------- - -- --------------------------------—--•-------- ---------------------- State work to be done and purpose of building (by floors)__irrxs-------- vct s_a _______ __________- ► -___-_- -------------------------------------------•-----•---------------------------- •------------------------------------------------------------------------------------------------------------•---•-----------------------•----------------------------------------------.and for no other purpose. New Building------------------------------ Remodeling--------._.__.-------- Addition------------------.------- Repairs_----------------------- No. of Stories------ ---................ To be constructed of-------------------------- Kind of foundation-----------.-----------------.--------------------_._--------- Roof Covering.-..-.-.-----------------------.-.-----------• AP- Estimated Total cost of improvements �.6-I5 ___Amount of Permit $______. - Zone cubage required-------------------------------------------------------------------------------Plan Cubage---------------------- Distance to next nearest building----------------------------------------------------------Size of Building Lot----•--------•------------------------------------------------------------------ Maximum ------------------------------- Maximum live load to be borne by each floor--------------------------------------------------------------------------------•---------------------------------- I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may besent to---------------------------------------- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida,Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. y� Remarks-------------------------------------------------------------------------------------- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared --------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------•---------------------------------------------------to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_-----_--------____--------_-----------------__---------- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated-4re true. 1�6 Permit No.— - ------------ Date.--/(�___�-/_1 _ ----- Read,Sworn to and Subscribed before me. Disapproved ........ - ----- Date -- - ------ ------------------------ -------------------------------- _ --- b_1 -__-------e-o-------------- -------------------------------------- Public,State of Florida (Signed) = . . . ---------- u ding Inspector My Commission Expires____________________________________________________ __________ PLANNING BOARD-------------------------------------------------------DATE Chairman ---------- ------------------------------------•-------------------------------------------- Member ---------------------------- Member -----------------------------...------------------------------------------------------------------ Member ---------------------------------------------------------------------------------- Member -- ----- ---------------------•---------------------------------------------------------------- Member ---------------------------------------•---------------------------------- - Council Approved-------------------------------------------------------------------------Date Disapproved -----------Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.......... 167.... Date.................... Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address.... .. . ��� o......� �... Street .. T.................... ... . , Street. r �..............._... . . . ....... Registered Architect and/or ngi er..... ........ . . ....... .................................................. .No...`.7 7 ...... Street....._...... Employing Electrician's Name.............. .............................c.,............. .__....__..... /.....................47 Location and Legal Description Lot....... .. k.....� Subdivision. V) ,7........................ ...................... �'J.. .. Street and Number where work is to be performed—No..4 T.. ....V... .....Bl�_®��.._. ... .....Street............................................_. State work to be performed and purpose of building (By Floors)...... . ........ New Building................................Remodeling................................Addition.._..__..__..........................Repairs......................................No. of Stories.................... SWITCH LIGHT PLUG FI%TURES REFRIG. IRON RANGE RANGE WATER W. HEAT. S�ACE STRIP �°Q/g� TOTAL OUTLETS OUTLETS R,EECCE/'P'T'S NO.LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HtPATER HEATER CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL, SW. CAB. TEMP. PERM. 0.1 HP 1-3 HP TRANS. LIST CHECK Overheadrgro / `� Service n eund Size Feeders... lG?..........Conduit--- �:i'-Main Sw_.. ...............Amps...........................Main Fuses....2 2.`�...........Amps Typeof Installation—Conduit......k!..............Tubing........................B.X.L.........................Metal Moulding..................................................................... ..... ..............................- ................................................................ ......................Ix.------*---..........._........................ ...... _.... .......... .... ......_. Amount of Permit $......... .4... ............................t`...................... (Signed).......... .. . . .. ...... ............ ............ .......... .............. c d 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 subcontractors, on work tp be performed under this permit, as are • Iicensed by Miami Shores Village. (Signed) Master Electrician. STATE OF FLORIDA, l COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared........................................................................................................................................................................................................................................ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.......................................................................... of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. .............................................................................................................. .............................................................................................................. My Commission Expires Notary Public, State of Florida NOTE: A reinspection fee of $1.00 will be made when such reinspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described.This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida,all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with,whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address_-__ ® Street._ I� _.._. f Registered Architect and/or Engineer-_ __ _____ — P m Employing Plumber's Name-_/V .A1Al-j®= P7-1 C, I,OA'k e-C No. .__._-----__.--- Location and Legal Description Lot__ Block -3 _____. Subdivision.__/_PL... q_..-.___.—. Street and Number where work is to be performed—No. ,_:�°!V f ----0.. State work to be performed and purpose of building (By Fly)- ---- ----------------•-----._._..-___-------..............---------- New Building----------... Remodeling —_.— Addition-____—_.___._._.. Repairs------------------------ No. of Stories........................ BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FOUNT'NS FIXTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE' SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LtBT CHECK Size Septic Tank----- -- 9-j6y-P-------�—,'Type of Tank__-----------------�—__�_.---------Capacity Gals.---._.----------------------- ------------ Feet of Drain Tile__—_✓� __� � . Feet of Tank or Drain Field from Well------------T—._._._.-__________._•_____-_--_._-_.-_................. Nature of Water Supply: City—Well. _____ _ _.—_.-_Size of Soakage Pit--------_--------- -_------.-...._----------_--------- Amount of Permit — - — (Signed)_ - Pl Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act,being Section 5988,Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) -'1�a Master Plumber.'-- STATE OF FLORIDA, 1 COUNTY OF DADE. j Before me,the undersigned authority,a notary public,duly authorized to administer oaths and take acknowledgments, personally appeared to me well known,and who,being by me first duly Sworn,upon oath deposes and says that he is the-___-......_....................... .�___..__..--•_----. ...._-- of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public,State of Florida —� NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made•neoessary by improper notice for inspection, or faulty materials and/or workmanship. BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL El Date— PLUMBING PERMIT 9166 Contractor's License No. { ROOFING ❑ ElWork to be performed under this Permit-- Owner ermit Owner of r Building Architect _ Contractor {' - or Builder ---- Legal Lox Subdi- Description Bl, vision Sq.Ft. Address of Value of Amount of -.�— Building '' �r{ �.• _ Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed " (INSPECTOR) BY-- In consideration of the issuance to me of this perms agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, swings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all ork done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER BY V AUTHORITY PERMIT APPLICATION FOR MUNI_CIPALLTIES OF DADE COUNTY `F (OWNER TO RETAIN COPY) Data A/1 Job Address 540 N.E. 103rd Street I Tax Folio f/ _1 gil /7 Ofd®t Legal Description , 'e ,Y Master Permit. ,7 � owner / Lessee / Tenant Roster Palmatier Owner's Address 540 N.'E. 103rd Street phone 754-0838 Contracting Cc. Ouality Roofing Contractor, Inc. Address 251 N.W. 99th Street Qualifier Carlos Arocho SSl4,. - ---- phone 751-0382 State¢ RC 0058627 Competency# 17889 &L Lf, Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BII=3NG XLECTRICAL PLMMIM MECHANICAL PAVING FENCE SIS WORK DESCRIPTION Tear off old roof, tin cap 30 lb. felt paper, mop on with hot asphalt 90 lb. felt and install tiles. On flatroof will tear off oic root tifl-cap 30 15. reit and mop on with hot asphalt Gaf Ruberoid.' Square. Ft. Estimated Cost $ 10,200.00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF AND YOUR FAILURE 'I DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YC INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF ) . Application is hereby made to obtain a permit to do work and installation as indicated above, ar on the attached addendum (if applicable). I certify that all work drill be performed to meet tt standards of all laws regulating construction in this jurisdiction. I understand that separat permits are required for ELECTRICAL, PLDMSING, SIMS, POOLS, RoMr=rx, and MECHANICAL work. OWNER'S AFFIDAVITS I certify that -all the foregoing information is accurate and that all wor 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. r �1``S na ofBw�e and/or Condo President Signature of Contractor or Owner-Builder atas , Date: _ f L Notary., as to Owner and/or Con(�p ppres dent Notary as to/Contractor or Owner-Builder My Camiss doT STATE OF CT. 10, sT I� C� ATE OF FLORIDA. * � =EXPIRES: OCT. 10. 1993• My Commissi Is R�$v�' BON THRU NOTA!PUBLIC UypER�YR1TERS pAP�RE$; OC U, 9993 7� BON0*THRU NOT PUBLIC U ERYJR'T=� PERMIT FEE: APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering t 1/ c� .y� STATE OF FLORIDA OOUNTY OF DADE 1 HEREBY CERTIFY that this is a true COPY of tftt p;E GOU.yp originalit in this office on�_ ay of �• � r � f Aed t � A.D. 19 9 WITNSSS my hz.id and Official Seal. lr Clerk Circuit Court , e h' i uD s4. ,.BVD.c, PERMIT #. Tax Folio No. e f®lf Z, o, ro NOTICE OF COMMENCEMENT Prepared By: Qulaity Roofing Cont. X41 State o f Florida Marylou Hernandez f8251 N.W. 99th Street County of Dade Miami, Florida 33150 co THE UNDERSIGNED -hereby gives notice that improvement will be made to certain real C4 propei-t.y, .and in accordance with Chapter 713, Florida Statutes, the following o. information is provided in this Notice of Commencement . CID 1 . Description of property: ( legal description of the property, and street address if available Xk n7 540 N E 103rd Street IX 2. General description of improveme t : Install new Tile Roof . 3. Owner information: a. Name and Address:—Roger Palmat;ier 540 N.E. 103rd Street Miami Shores , Florida b. Interest in property: owner c. Name and address of fee simple ti;tleholder(if other than owner) : 1JZA i 4. Contractor : (name and address) Oualaty Roofing on rae .nr, Tnn- 251 K.W. 99th Street Miami , Florida 33150 5. Surety: a. Name and Address P/pr b. Amount of bond$ 6. Lender : (name and address) 7. Persons with 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) N/ & 8. In addition to himself, Owner designates of to receive a copy of the Lienor ' s Notice as provided in Section 713. 13( 1 ) (b ) , Florida Statutes. 9. Expiration date of notice of commencement ( the expiration date is 1 year from ' the date of recording unless a different date is specified ) i atur Owner Sworn to and subscribed before me this _day of , 199.. NOTARY PUBLIC STATE OF FLORIDA: MY COMMISSION EXPIRES:OCT. 10, 1999. BONDED THR .jq RV ni,-.; � Notary Pub isMy Commission Expires. UN FR`VR`TER9. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date // /� Job Address 5 �® fD�s'�' ml?4 Tax Folio Legal Description ��� IT �� 3 IWC/ ShvA td- �e©� Owner / Lessee / Tenant r6,09 u �✓�?� 2� Master Permit # Owner's Address 5-y® A /o? Phone -,7M- d-fP lrl Professional General Contractor, Inc. Contracting Co. X275 NF 14 Avenue Address North Miami,FL 3311 Qualifier ��? i��_____ Phone do�� State # 00-f431 Municipal # Competency # Ins.Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION S ! � � ✓� ® J ®ems �/ ��2 Square Ft. Estimated Cost(value) 400 o® WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT) . Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable) . I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authori the above-nod _contractor to do the work stated. S' atu e o own an ondo-President- Signature of � L b' �- Date: ®FFIC OT RYSEAL Date: IIL�SPMA NOT/ L BFZA dIIUIARY FUL?1-I(' (F LLQR1 DA OT JB FLnFTnA. P4A.9R ,1' Notary as to Owne �h iqtx.i President' Notary as to My Commission Expires: My Commission Expires: FEES: PERMIT' RADON C.C.F. _ NOTARY TOTAL DUE 3 APPROVED: Fire Other Zoning Building�= � Electrical Mechanical Plumbing Engineering Z071 ti d ---- 75 _ r"-� T1 d 00 Z LL '^ LEGAL DESCP,=CN: a 1 LOPS 768 BLOCK 93, APOMED PLAT OF o �9 �1 �O kr 1 o, \ \ NIIANS SHORES SECTION N0. 4, acxo+•�;*+; \ o�� � 0 to the Plat thereof as recorded in 1 PLAT BOOK 15, PAGE 14 of the Public Records of Dade County, Florida. Q �' a pGpp0j zO f pQ k CERTIFIED TO: Palmatier, Robert J. and Louise N. EXPRESS FINANCIAL CORP. a Florida w 1 z g Corporation p HOWARD SCHWA rz, P.A. o L ATTORNEYS TITLE INSURANCE FUND, INC. p zo LV r!l!1/ its.- lobi LO -�?.r,/��i�-o,/'!�/�Gimes � �•r; zz u, CERTIFlCA7E Elevatioro shown hereon are vdtft reverence to NOT VALID I hereey certihr that thta slm�eh� of�hereon the National Geodetic Vertical Datum unless UNLESS SEALED aesd+bmeurvey Bisadonw BASELINE ENGINEERING mad otherwise noted.underground features.It airy, WITH THE acarrate and correct to the best of nrY w,owledgeardb AND Identified nor located except as may be indicated ballet.and uNess oNerwisa ahow4 there are m visible EMBOSSED SEAL erx�d°"ama I turttrer certiry test me curvet rapre SURVEYING, INC. rp,s hereon. sented hereon meets the Mintinum Technkel aterxfards This survey shows platted easements and right. OF ash s�toBrm�byQeFlo eco Rof om Land NORTHERN TRUST PLAZA*301 YAMATO ROAD of-way.There may exist additional restrictions CERTIFYING Code.pursuant to Section 472-OV Flo Smbaes BOCA RATON,FLORIDA 33431 it!E'• /Oy ST.PEE T and/or encu which effect this property. SURVEYOR Date: s=ue- -/Z d . a u SCALE: u JOB NO. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No.--- c I , .... 1st----------- 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 Engineer---- Employing ngineer-_ ._Employing Plumber's Name------_-&L b, =s G7 i No.— stre" sF Location and Legal Description Lot_______ > Block _-___. Subdivision.._ __ -__-_ __.. Street and Number where work is to be performed-No. Al� street_----------- � Jf31�,_-------------- State work to be performed -------------------- ,1^� y ®w 6 and purpose of building (By Floors) Ped_,..i—_--___ ----_-------_ --_-- S'-`= __ ----_---------- Building-- -_-----------Remodeling Addition-----_-_-_._ Repairs---------------.---..__- No. of Stories.-_....-_...___------_ CLOSETS BATH SHOWERS LAVA SINKS SLOP LAUNDRY URINALS CATCH FLOOR DRINKING ®/„Stj 6-44-9 TOTAL TUBS TORIES SINKS TUBS BASIN DRAIN FOUNT'NB �/ 'p��`� FIXTURES CLIIVSTTR CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE' SOLAR DEEP SPRKLR. SWIM'G I TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIR A CHECK Size Septic Tank--------____- Type of Tank_._-_-------------------------------------__-__-Capacity Gals---------------------- Feet of Drain Tile-_--_- ---___ _Dist. Feet of Tank or Drain Field from Well...... _.------.-_--------------_________.__.....-.-•._-__-- Nature of Water Suppl Ci . ell. _---__-- -----..Size of Soakage Pit---------------------____.---__-__-------- Amount of Permit (Signed)__ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acees his obligations as an employer of labor under the Florida Workmen's Compensation Act,being Section 5988, Compiled General Laws of Flori Permanent Supplement, and has com- plied with the provisions thereof,and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) _ ------------_-------------•--_-•- - Master Plumber.STATE OF FLORIDA, 1 OL V 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 cath deposes and L says that he is the----------------------------------................... ....-__ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public,State of Florida---__._.._. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. L V-1 CID ly �'-•. CQ �� PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date "?/) 2 ' f Job Address �" t'0-3 S i" Tax Folio �g I Description Historically Designated: Yes No Owner/I.essee/Tenant -L Master Permit# 41 4�2 _ Owner's Address r'"d � ( _CZ Phone —( q-5 ©© 4 Contracting Co. E-ls/ �, PO 0,6 Address 16 00 r c` S Qualifierlam/ S S SS# hone 000-0 eA State# ��iJ�� Municipal# Competency# Ins.Co. Architect/Engineer Address Bonding Company Address Mortgagor Address P Permit Type(circle one): BUILDING ELECTRICALLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION R® o C— pt �Q" 0 0 Square Ft. Estimated Cost(value) ?o CD 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 accura and that all ork a in compliance with all applicable laws regulating construction and zoning. Furthermore,I authorize the abov am contracto to do or ted. Signature of owner and/or Condo President Date Signa o on cto or er ate Notary as to Owner and/or Condo President Date rconuniPonExpires:as tactor or Owner-Builder Date My Commission Expires: 14�_ FEES: PERMIT RADON C.C.F. NOTARY BOND TOTAL DUE _ APPROVED: Zoning Building A Electrical,2 Mechanical Plumbing Engineering PERMIT APPLI/CATION FOR MIAMI SHORES VILLAGE Date Cq Y Job Address � /" .�( Tax Folio Legal Description Historically Designated: Yes No Owner/I.essee/Tenant (ffl�t4t M A Ti e-K Master Permit# Owner's Address f�to �� �--� Phone Contracting Q. Poo 6 J''C Address 119 C3 0 PC I J � Qualifier e Ess tSS# - !v - Phone 0 State# p� 1r O f municipal# Competency# Ins.Co. Architect/Engineer 494th C_CJtl S& IrbIl °Address Ste/ 5T A-lr- - / t ,-Yc Bonding Company Address AA Mortgagor Address Permit Type(circle o eE: B:UIE:1LDD1NG--�4LECTRICAJL PLUMBING MECHANICAL ROOFING PAVINq FENCE SIGN j WORK DESCRIPTION Square Ft Estimated Cost(value) A 0 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 accuratep at all or will be done in compliance with all applicable laws regulating construction and zoning. Furthermore,I authorize the above- ed frac r to work sta a L{ 4 sign e o or n President Date Si ature C n or uilder Date No as t e or Condo President ate Ar S H E Rft A ate My Commi mo� ,�.� S�E���� =21 OTARY PUBLIC,STATE OF FLORIDA y Commission Expires Malt 2"4.1999 NOTARY PUBLIC,STATE OF FLORIDA Commission#CC 467710 My Commission Expires May 24,1999 Commission#CC 467719 FEES: PERMIT RADON C.C.F. NOTARY BOND TOTAL DUE APPROVED: Zoning Building Electrical s�l^u,d• Mechanical Plumbing Engineering MIAMI SHORES GILL AGE BUILDING DEPARTMENT PLANS EXAMINATION SHEET JOB SITE: 540 1,1E DATE: TYPE OF REVIEW: �S�j°��. BY: �O - - � - - - - - - - - - - - - - - - - - - � - - - - - - - - - CODE SECT-70N PAGE LOCATION C%^J MENTS s ,- 4ra r� ed 5eewnl a / r le4c e �0 Iolav , (-51-le lvla4) - i ' f Al C h - �- M 30100' 60• 5204 . • IZ // i0 9 8 7 ��° 5 4 3 2 r� 5o' `50 . /. I . ar/3 14 ' /S /to 17 t8 /9 20 2/ 22 2,3 24 3v5D' 35' h 5 0Lzea) b nt� n — --1�- t • Scam i /oo' , f SEMI or SUM • f o i f •t l • i Lots 7 and 8j loch 93, MIAN 880888 SECTION FOUR AMENDED according ' to the plat thereof, as recorded in Plat.Book 15 at Page 14 of the Public SecoQ40 efDade County, Florida. ! ORDER 882929 Date: dune 25th, 1963 • ! 1P.B.81246-24 scales Shown i I I HEREBY CERTIFY: That the attached "SKETCH OF SURVEY" of the above described property is true and correct to the best of my knowledge and belief as recent- ly surveyed and platted under my direction. ese bl 1 octafes, V.Pres. eg s e;e h ury y�r 5 State o Florlq. i E V I S I 0 N S / f Order No, Date Field Book • ' e': } �' '?- Gt` y �s8�s e an ury tate of Kja. so U W.Land t F1 1.or State of la. Reg. L-antr 'S*UTV Cyt? 1 a. e.I'and`5ur�veyti, r'C f+ >� �`q��� .�A irr�t � \\t liS+pp V� � � !� r � f(�t•J A• rT Y.I. "f` /\{.ly 4e( �^ ` I .r �\ ����,�.1 I•.�'�i"'YY'�i� ��'S���li���E.��f'' �t Irk 7��`� ��J � I l� M Y 1i f:.y,� 3`t {I � .tt. r �} iiY}F-.1i.'f��C}8" t�. {. ,{ �J r •t: �zr �SPr[r rt •i1 ed Y. �, V: Y �I" .�j 5 �� � �j-y��yr/jr� e. '•� d� ix QY{�(J r{1..��t�s.\ l' .5 i��Q:it�.. ��� � �{�/I//•'r'j.��:r`�(.{O+f,�j wi ,r�.' 4 a ... m Gross Area S's WAI i3.5 e� � 0 a , ,110. Q0 i in�• m 5.o COVERED PORCH 4230 /6.85 •'•..; 1 V 24.70 d Co 2 Sfy C.B. S. #540 h /7./0 Q) N N : 40-80 a o •/I ,e a r � /00 ti t�.� n4�. '•:. r`���+•YR - 5. -'t1 Y. .1 � y., ♦r �� v� x ni^1{QTc f��� , ' j4 •( �:G'Pll ,���•�` .r..k 5 .. 1 � 4q,T��1 1� SS Scale / `?o r TYPE: EXISTING MAIN BUS: SERVICE: 24OV, SIN PH 3W M A 11 1 "O U S E P Al l E L. NEUTRAL: FULL MOUNTING: RECESSED SINGLE PHASE 120/240 42 CIRCUIT MAINS: MCB F O ELECTRICAL LOAD SUMMARY POLES: 42 alc 10K A. GENERAL. LIGHTING LOAD AND SMALL APPLIANCE NO REMARKS WIRE CON- TRIP NO. DEM NO. DEM TRIP CON- WIRE REMARKS NO DUIT POLE KVA KVA POLE DUIT 1881 SF. AT 3W PER SF = 5561 + 3000 WATTS 8661 WATTS 1 AIR CONDITIONER 8 3/4 40/2 6.$ 12.0 50/2 3/4 6 RANGE 2 B. FIXED APPLIANCES: 3 12 L 4 1 1 RANGE 12000 WATTS 5 AIR HANDLER UNIT 10 1/2 30/2 5.0 1.0 20/1 1/2 12 REFRIGERATOR REFRIGERATOR 1,000 WATTS 12 20/1 1/2 12 DISHWASHER 8 w P DISHWASHER 1,200 WATTS w � WASHER 1,500 WATTS 9 WATER HEATER 10 1/2 30/2 5.0 0B 20/1 1/2 12 DISPOSAL 10 10 4 DRYER 5,000 WATTS it 5.0 30/2 1/2 10 DRYER 12 Cn 1.L ca d WATER HEATER 4,500 WATTS 13 SMALL APPLIANCE 12 1/2 20/1 1.5 L 14 66 DISPOSAL 800 WATTS 15 SMALL APPLIANCE 12 1/2 20/1 1.5 1.5 20/1 1/2 12 WASHER 16 W Z z DOOR 800 WATTS MICROWAVE 1,200 WATTS 1'1 MICROWAVE 12 1/2 20/1 12 0.6 20A 1/2 12 GARAGE DR OPENER 18 w O z POOL PUMP AT 1009- _ — POOL LIGHT AT 1009- - 2,400 WATTS 19 LIGHTS RECPT 14 1/2 15/1 20/I 1/2 14 LIGHTS RECPT 20 1 1 21 LIGHTS RECPT �4 1/2 15/1 20A 1/2 14 LIGHTS RECPT 22 < Z _ CONNECTED LOAD LESS A/C SUB TOTAL 3%161 WATTS 231 LIGHTS RECPT . 14 1/2 15/1 20A 1/21 14 LIGHTS RECPT 24 —1 Q LESS 10,000 WATTS AT 100% - 10,000 WATTS 25 LIGHTS RECPT 14 1/2 MA 20/1 1/2 14 LIGHTS RECPT 26 q REMAINDER OF WATTS At 409- = 11;664 WATTS 21 SPARE 6.61 40/2 1 6 HEAT PUMP 28 A/C OR HEATING AT 1009- = 6,500 WATTS 29 SPARE L3o POOL HEAT PUMP AT 1009- = 6,610 WATTS 31 SPARE 2.4 20/1 1/2 12 POOL PUMP 32 TOTAL 34035 WATTS 33 SPARE 34 DEMAND LOAD 35 SPARE 1.0 15/1 1/2 12 POOL LIGHT 36 34,835 WATTS / 240 VOLTS 145 AMPS 31 SPARE SPARE 38 Q SERVICE SIZE = 150 AMPS 39 SPARE SPARE 40 3 c c C.NEUTRAL LOAD: 00 41 SPARE SPARE 42 L r a a LIGHTING, SMALL APPLIANCE, AND WASHER - 10,161 WATTS FIRST 3,000 WATTS AT 100% = 3,000 WATTS 3 "12 IN 1/2" COND 1P, 15A ci ci REMAINDER OF WATTS AT 3596 = 2,506 WATTS 15 AMP SWITCH _ 3 AZ RANGE X 1090 8,400 WATTS IL DRYER X 109. 3,500 WATTS 3 08 IN 3/4" COND 2P, 40A N L z TOTAL NEUTRAL WATTS = 3 N2 IN 1/2" COND 2P, 20A :X " 11,406 WATTS / 240 VOLTS = 12B AMPS EXISTING EXISTING 20 AMP WP SWITCH EXISTING FPL METER 0 AMP _� 15 SERVICE CAN PANEL 40 AMP WP SWITCH a TC POOL MOTOR PUMP A-32,34 Z O ci HEAT PUMP MOTOR A-28, 30 r LIGHT FISEROPTIC SOX 0 POOL LIGHT POOL 15 AMP W.P.GF.C.I. n Q w _ Z 10 A-36 DECK RECPT. A-26 / Ll � Ilt 10 / / ® N FIBEROPTIC 01 CABLE T _1 � r POOL ELECTRICAL SCHEMATIC s �' PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 9/19/97 Job Address 540 N. E. 103 St. Tax Folio Legal Description Historically Designated: Yes No OwnerA,essee/Tenant ROGER & LOUISE PALMATIER Master Permit# 41846 Owner's Address 540 N. E. 103 St MIAMI SHORES, FL. Phone L754-0838 6-11 Contracting Co T & M ELEC 'RIC, INC. Address P.O. BOS 3501183 MIAMI, FL. 33135 Queer ANTONIO MORENO SS# a 880-1408 State# ER-0013719 Municipal# -3,�(07aW Competency# 94E000420 Ins.Co. GRANADA INS• CO• Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION SWIMMING POOL Square Ft Estimated Cost(value) $ 625.00 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 work and installation as indicated above,and on the attached addendum(if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL,PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore,I authorize the above-named contractor to do the work stated. 9/19/97 Si a wn aZnd/or Condo President ate Signature of ontractor or Owner-Builder Date kaly MORENO Notary as to MGer and/or President ate Notary as too��tor or Owner-B ' er ate My Commissi ires: My Commis ' ues:Mr RESA° �gg991s AESA CEOAs E 18,1999 My cmwd"kn MUM 5 E)*m Aug.16.1999 FEES: PERMIT �l'�� RADON C.C.F. NOTARY TOTAL DUE APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering e PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ZZf Job Address 5-40 I� E 103 STV'- Tax Folio Legal Description n Historically Designated: Yes No Ownerd=ce/Tenant t.- PQ Iv,4 g4-Ce n Master Permit# Owner's Address S-4 C !`j E /2 3 St-p-e e Phone Contracting Co. 14 (( e Gf it " C— Address E '7 ? e e 7 Qualifier Q%j< Q d GQ-S SS# -5- 7-r 7 State# E iQ Municipal# r 3 2- 3 S- Competency# Ins.Co. Architect/Engineer Address Bang Company Address Mortgagor Address Permit Type(circle one): BUILDING LECTRIC PLUMBING MECHANICAL RrOOFING PAVING FENCE SIGN WORK DESCRIPTION 0-C `� 0 9-" -( a -dl1�- Square Ft Estimated Cost(value) l d 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR MROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum(if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL,PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Lore,I authorize the above-named contractor to do the work stated., jWe i 0 or Condo President Date Signature of Contractor or Owner-Buildcr Date " V9 �u-racna�y /(no�-rt 1� Nolary as to Owner and/or Condo Date NotaryXao Contractor or Owner-Builder ate My Co t 1' too My ssion Expires: my cW=W8i0ncCS1()M P wmtwk ®MM18810M tW11� Yerene C e �.4012 m(t�o exams Match ms.2�1 j ., i9� ®�Ytt119d►�M i ''earw�� FEES: PERMIT RADON C.C.F. o �� NOTARY .5 - BOND TOTAL DUE APPROVED: Zming Building Electrical Mechanical Plumbing Engineering •hkight__. 2' AIICIVE RnOF _ Conductor size— DRIP LaUr � ca�utt size_--- z - TO BE 10, conduit -Lypf-____����l-- A1-v (MIN) - '`- Thru(4sof Y Es��_rcn Ground wir _ NAIIJ DISQ.0NI1ECT --- - Ra•bn0 __;Ld0 Amps .. -. Moen A00 o _amps Sub $reialcer-s Amps SUB FEEDER ER New Existing '__ MAIN CD - SU3 CB Type ~� PANEL - size Sue. r '200A zPA NCL - aawoc 11•ISIDE PANEL r Pt nri� Rang _ - a,ps euaa�ic - Dond Buss _Yes - �GL AJ 7L1 OF bf}OE L� - GnAA • PERS .F . 0 -C , n5n5 , CONTR/ 3�0ft-lLfINSE- VE CLAHP S I GHAT 21 OF CONTRA TOR _M CLAliar N 0. A R .— ._,__ My co i ,ccs+orn T6 M— F1111SHED rRAIE T U/W x Ir t; A {� � � n -U' MIN DEPTH aun wtw �--! I E D B Y- i r' r`TnTA t T, TTTnn i r ADcNDUY TG BUILDING PcRMIT IPPLICATTON FOR -u_:7«YG '-'u1`wr�=C��.^.�_Y}_' AD-EXXIDUI-d. rz��'��5�. Els rT�:: mr -Nus. UMBTNG ELECTRICAL MECHANICAL 17J LqT i—c: I a- WIT rct I,a lxrr F:: 3 «:i<, ZE SRI Mi WTOTS S?AC fr'i�,cRS17 Ltrn? a TUIS Gz;ITRAL t iT1i ! 71st I I I .aa"E MM l ! ( (oria) l I g 3;s-amu. ! I { smtc:- Tv a m I A/C (CEL) l l ;�Ntcl>as ��tTaIH I 1 I NICE SIZE IN AWS t I ( ! I g V-= LO4AIN ! I I SSYiM :EMR/l¢iS CUNGE200I 1 I I RERIG&ATION ! APP!IMa aM—FS I l I °c= )a was PIPING I l R:rG vaTtRY I I aveI I I :WE GUM TM u- vta s I I S a 1 ;t? I i I S-1cm IMIL'S I i r I I 1 M31- S a-ve 1- 3 "-p I ( f ?UT AAS MILS I l s:XX. POT/2 =F. i ! I s WE 3- : vWIUTIGN I I 3,'A. RES; I i I SDTCRS ave r 3 I I I Tits a LILIES I I a.p f I I u>Tm aver a- to I i I ��ATaE;su I :.SAY u L �, I i i �=Rs avE 10- :5 if l l I F!RE PRIM—S MW I I _ • !:1. I I i sa T tis ova 5-cca CML us 1005 I I U CSE' I 1 Affm we Ica �p I I I VICLATION I 1 f!AeT YASM I I I aR IIII' it f I ! qE:NS=MON I i =:C UNIT I I I mP I I I �ENERATCRS lMGM6M I I t l ! etF �41�`QQ_�`t ::TS-4e IitS'i. ► I I GDEF,TW i u I rt:. RAMZS T is ! I I _::!x si�tN1Q_' ! 1 ! l 5 '4,x �ntutlras aJGL I t I attus c5ecix YA-ir--R SE-tVICC- I i . i sm ,as I ! I ► I S-=, w" "ICJfS I 1 I SIQI iRakSrt am I { ! I I Sim Tile CL= I 1 l { I cr:t:�r-anT� I I I F amm I I I I I SF-1 tc Tarac I i I utrtseu► i I I I ! + TE---vlstaN a ur s I t I I I I ORMI IU. 4- TILFjM. i I I vl»nCN I I I l I I F.34" b .'.8A,m SEPTIC Tate( I i3Et1Lr�71Qt I I I I 1 I SCAXa PIT M. F,T. '!S1N oi. I I f I l I I ,:Rt:,; AMAIN I I I I 1 I I I `G LINN AS