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1200 NE 91 Terr (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / 726r f7 Job Address l - 0 4)6— 4 1/ 7 `ei-- - E Tax Folio 1-67 6 Legal Description Owner/Lessee / Tenant . Owner's Address I 7 ? / 4 Contracting Co. e/e � L v s /3-s71 j /Z._ Qualifier 4 L 6 4 S% /1 �� SS# Phone 95 state# EC-' 01, /2_97 Municipal # Competency # Ins. Co. Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING WORK DESCRIPTION Signature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMITA5 storically Designated: Yes (0-4)--+--/ Masteft t Phone No / 0 (7 %3 ELECTRICAL P , UMBING MECHANICAL OOFIN� G FENCE SIGN 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. Date Date RADON C.C.F. edv Signature of Contractor or Owv�nner- Builder C a 72 S Date - L � /_ i2 38'9� 'b72 Notary as to Contractor or Owner - Builder My Commission Expires: 2 - Date 60 NOTARY 5 BOND TOTAL DUE 5 'eg ) APPROVED: Zoning Building Electrical 6'f Mechanical Plumbing Engineering ONSTANT eLECTRICAL ' ') ERVICES, INC. per .. C. k- Ce4Lv.J ult„ d 9 -r $ 9 ictt d aft 770A, 3J _ d am a- /2 _ea (i4-4, PATRICIA J Lb1CL My Commission Expires Sep. 05.1 Bonded by ANS -1 4142c14 1 L State Certified Electrical Contractor #EC0001287 1354 S.W. 12 Ave. • Pompano Beach, Florida 33069 -4629 • Phone: (954) 9 -6111 • Fax (954) 783 - 51."50 - tS c C���1 c.rc1■ \ci. WORK DESCRIPTIO PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ‘ ' °? i C / - Job Address 4 ?M G. 9/ hit Tax Legal Description Owner / Lessee / Tenant Owner's Address Contracting C Qualifier L�r� ! ,..� , , � ` SS# Phone MM State 1 i icipal # Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDINECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN A L 2 O 4 et Competency # Square Ft. Estimated Cost(value) \57 br 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 c•m•p ance with all applicable laws regulating construction and zoning. Furthermore, I ON) if liA4411 oriz: e -,ove- med contractor to do the work stated. natu•Y 'f a and or Condo President Date: Notary as to Owner an My Commis * * * FEES: PE APPROVED: or Condo President un , c, *pi res ,. �• ,f Jhh •• N010041 JCML i rtlhoLN } ::Iww.w:.l�lvi rl��id "cN J }' *VCJ4dlek47 * ••• ..1 J GUe 0/1144lol, WO' tvi 1,1 1 '4 Zoning Mechanical * * * "1, C.C.F. ©SL/ Folio // Master Permit IP Phone 193 Ins .Co. Signature of Co tractor or Owner- Builder Date: Notary as to Contractor or Owner-Builder Fire Other , Building Electrical t Elm-thing Engineering__ o Lat Owner of Building �aCC// Architect Contractor or Builder Legal Description 1 1 B1 Address of / Building J c 6'41 *2 e� CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA Date _ ? 19 BUILDING ❑ ELECTRICAL PLUMBING ❑ PERMIT N9 8797 ROOFING ❑ Work to be performed under this Permit ■ I I I Subdi- vision Contractor's License No. ! 2,2_t Q 3 ,44"' Sq Ft. Value of 11 Amount of Project $ II Permit $ 7 BY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with an plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed • / /' �/� �` (INSPECTOR) BY In consideration of the issuance to me of this permit I ree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, dr . rings, 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, agent, servant or employee. AUTHORITY r Permit No.__!! _ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street__ ' ` _ ____��__�'Ca Registered Architect and /or Engineer Amount of Permit $ _. - SS. ..Employing Electricians Name -- : T • -C — Y - - e: tr — r _ j La a , vC • Str eet •'""• Location and Legal Description Lot Block Subdivision_ — Street and Number where work is to be performed —No " • - Street - e_ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition. Repairs No. of Stories My Commission Expires (Signed) Date . 1 .�L ; ` - -'7 1.00 Service Overhead Size Feeders Conduit Main Sw Amp. _ __ ______ p.. Underground s Main Fuses Type of Installation — Conduit 7111; 71 :.:CL Metal Moulding -- --------- __;i7• (Sgnzd� �Q The undersigned applicant for *'fis `. permit does hereby certify that he understands an under the Florida Workmen's Comp: -,atit:n Act, being Section 5966, Compiled General Laws of plied with the provisions thereof, and requir.; similar compliance from all contractors or sub - performed under this permit; and viii ::t or cause to be posted fcr inspecti :m on the site of required by the Act. The under sigr.z i a Tees tc employ only such sub - contractors, on work licenses by Miami 5 . res V!ii ge. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths L. Notary Public. State of Florida Electrical Inspector. d accepts his obligations as an employer of labor Florida Permanent Supplement, and has com- contractors employed by him in the work to be the work such public notice or notices as are to be performed under this permit, as are 1 , -. i Master Electrican. 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACI HEATER STRIP HEATER 'a O17 TOTAL CONTR. LIST + • 10 1.00 CHECK ,2.• G0 i 2.00 ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. _ ,, . �'V. ' . C:; MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST __- .. �;• i _.. 't / �_ /1r7;} r , 1 . _ I` 77 7 1 ' 00 CHECK UfC "- - — .PI r Permit No.__!! _ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street__ ' ` _ ____��__�'Ca Registered Architect and /or Engineer Amount of Permit $ _. - SS. ..Employing Electricians Name -- : T • -C — Y - - e: tr — r _ j La a , vC • Str eet •'""• Location and Legal Description Lot Block Subdivision_ — Street and Number where work is to be performed —No " • - Street - e_ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition. Repairs No. of Stories My Commission Expires (Signed) Date . 1 .�L ; ` - -'7 1.00 Service Overhead Size Feeders Conduit Main Sw Amp. _ __ ______ p.. Underground s Main Fuses Type of Installation — Conduit 7111; 71 :.:CL Metal Moulding -- --------- __;i7• (Sgnzd� �Q The undersigned applicant for *'fis `. permit does hereby certify that he understands an under the Florida Workmen's Comp: -,atit:n Act, being Section 5966, Compiled General Laws of plied with the provisions thereof, and requir.; similar compliance from all contractors or sub - performed under this permit; and viii ::t or cause to be posted fcr inspecti :m on the site of required by the Act. The under sigr.z i a Tees tc employ only such sub - contractors, on work licenses by Miami 5 . res V!ii ge. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths L. Notary Public. State of Florida Electrical Inspector. d accepts his obligations as an employer of labor Florida Permanent Supplement, and has com- contractors employed by him in the work to be the work such public notice or notices as are to be performed under this permit, as are 1 , -. i Master Electrican. 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. 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.