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1263 NE 93 St (6)Date Legal Description )1 l 44Ly Zrot Cat p e L k I L.(' P LF k-I _1na.1A IVY Hey Owner/Lessee / T Owner's Address / d 6 3 Contracting Co. Z //IGr /Gd tl l. f Qualifier /7u � ∎r 4 / State # Pa:_ . Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA PLUMBING)IECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Penloegi Xcd << b . C • �� e : .,.cllG r ?i9e. Of " .4..°'Ji / Square Ft. Estimated Cost (value) 300 (7D 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 NOTIICE 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. D A. IANNAC NO E n i " MY COMMISSION # CC 670128 EXPIRES: October 9, 2001 ... Bonded lbw Pu.. Sign Notary as to Owner an or M Conunission Expir cL FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE J o b Address's 13 N c j S (!mss Tax Folio I 3 Z °5— O Z 7 0 1 b o RADON Date C.C.F. Historically Designated: Yes Address /7.5Y JAY Rol. ss# .. Phone S3 /- 7®!7 Competency # Address Address Signature of Contractor or Owne - uilder 13,4 Phone otary as to Contractor or Owner - Builder ,„> My Commission Expires: APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering No Master Permit # L% 7 qv J (74.2g9„..5 L 2g S 7s -2,221 Ins. Co. lei/P Date Date NOTARY BOND TOTAL DUE Size Septic Tanti Feet of Drain Tile Nature of Water Supply: City —We1L Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT � Permit No Application is hereby made far 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 mud be kept at building during progress of work.. 9�� Owner's Name and Address I "� Y ► ^ , Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot B Street and Number where work is to be performed —No.i a 6 -, A` F q 3 4 Street.. — ... —.. - -- State work to be performed and purpose of building (By Floors) _____.... -. New Building_ _ ._ ____ -.. Remodeling —__ Addition.. - _—_..Y Repairs- No. of Stories. ......... Type of Tank — nlst. Feet of Tank or Drain Field from Wall Size of Soakage Pit. ( Signed )- No Street.. ..,cn ..s...._ ..n.,,. itrMea., ®..:....�..,a cz -.. ,,,.,,. • - Subdivision - =1 M Commission Expires Notary Public, State of Florida tor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors b- 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 alt . the work such required by the Act. The undersigned agrees to employ only such subcontractors, , k' •. to be perf licensed by Miami Shores Village. ce or notices as are this permit, as are Master Plumber. STATE OF FLORIDA, f a. 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 wefulb► read the foregoing application, and that he did dgn the same„ and that all fads therein by him stated are true. NOTE: A re inspection fee of $LOO will be made what snob millepedes is made•naoasary by Improper notice for inspection, ©r faulty materials and /or workmanship. CLesrT[ BATH Tu e[ SHOWERS RYA• TORIES SINKS SLOP SINKS LAUNDRY TOSS URaNAIS CATCH BASIN 'FLOOR DRAIN DRINKING ROUNT'NS TOTAL - FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR NEATER DRIP WELL SPRKLR. SYSTEM SWIM'O POOL — - CostrL. LIST �® �--° i t CHECK Size Septic Tanti Feet of Drain Tile Nature of Water Supply: City —We1L Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT � Permit No Application is hereby made far 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 mud be kept at building during progress of work.. 9�� Owner's Name and Address I "� Y ► ^ , Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot B Street and Number where work is to be performed —No.i a 6 -, A` F q 3 4 Street.. — ... —.. - -- State work to be performed and purpose of building (By Floors) _____.... -. New Building_ _ ._ ____ -.. Remodeling —__ Addition.. - _—_..Y Repairs- No. of Stories. ......... Type of Tank — nlst. Feet of Tank or Drain Field from Wall Size of Soakage Pit. ( Signed )- No Street.. ..,cn ..s...._ ..n.,,. itrMea., ®..:....�..,a cz -.. ,,,.,,. • - Subdivision - =1 M Commission Expires Notary Public, State of Florida tor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors b- 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 alt . the work such required by the Act. The undersigned agrees to employ only such subcontractors, , k' •. to be perf licensed by Miami Shores Village. ce or notices as are this permit, as are Master Plumber. STATE OF FLORIDA, f a. 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 wefulb► read the foregoing application, and that he did dgn the same„ and that all fads therein by him stated are true. NOTE: A re inspection fee of $LOO will be made what snob millepedes is made•naoasary by Improper notice for inspection, ©r faulty materials and /or workmanship. c' Permit No -4_ 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. 0v/flea's Name and Address F. No. 1263 Street NOE, 93rd Street Registered Architect and/or Engineer — Employing Plumber's Name ABC SE.ET1L TANK SERVICE No. 3123 Street_ I\T elPie 54th S Location and Legal Description Lot__ ....... _____________ Biock Subdivision Street and Number where work is to be performed-No State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Feet of Drain Tile Nature of Water Supply: City-Well Amount of Permit $ STATE OF FLORIDA, 63. COUNTY OF DADE. MIAMI SHORES Val. GE PLUMBING INSPECTION DEPARTMENT Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well Size of Soakage ?it APPLICATION FOR PLUMBING PERMIT ( Signed )_ Street 1 ,- - lumbing Inspector. i The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob1igatioi as an employer of ilabor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent St4plement, 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 unyl a this permit, as are licensed by Miami Shores Village. (Signed) .0 1 My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-fatspection fee of $1.00 will be made when such re-inspection is made •flecessery by improper notice for inspection, or faulty materials and/o11 warkgrnmhip. CLOSETO BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST .....=....... CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST 40 CHECK c' Permit No -4_ 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. 0v/flea's Name and Address F. No. 1263 Street NOE, 93rd Street Registered Architect and/or Engineer — Employing Plumber's Name ABC SE.ET1L TANK SERVICE No. 3123 Street_ I\T elPie 54th S Location and Legal Description Lot__ ....... _____________ Biock Subdivision Street and Number where work is to be performed-No State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Feet of Drain Tile Nature of Water Supply: City-Well Amount of Permit $ STATE OF FLORIDA, 63. COUNTY OF DADE. MIAMI SHORES Val. GE PLUMBING INSPECTION DEPARTMENT Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well Size of Soakage ?it APPLICATION FOR PLUMBING PERMIT ( Signed )_ Street 1 ,- - lumbing Inspector. i The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob1igatioi as an employer of ilabor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent St4plement, 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 unyl a this permit, as are licensed by Miami Shores Village. (Signed) .0 1 My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-fatspection fee of $1.00 will be made when such re-inspection is made •flecessery by improper notice for inspection, or faulty materials and/o11 warkgrnmhip. BUILDING ELECTRICAL PLUMBING ROOFING CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Na 7390 Owner of Building Architect Contractor or Builder Legal Lot Description II Bl. Work to be performed under this Permit Subdi- vision DATE 19 Contractor's License No. Address of Value of h Amount of Building t - %- i Project $ ' I Permit $ `-" This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: ' INSPECTOR In consideration of the issuance to me of this permit I agree to perform tie work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plane, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac• cepting this permit I assume responsibility for ell work done by either, myself, rr.y agent, servant or employee. FY AUTHORITY AY ROT' s CLOSSTS BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS RINALS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS ( - . :' TOTAL FIXTURES CONTR. LIST c - ) <- .. _ , / // ) 1 CHICK r J �% � . � Y/c ,C fir -��� / , `i X SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM - 6 POOL. -- \ j� ". G Casa. LIST CHICK ... ' l/ )� % " - ) Permit No -- -- 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 ?rdnce 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---- --- - -- -- "' -- - --- = --�- ---- d- ---- __-- _-- •-- -- -_._ No. A ."�- ---- -- •-- -- - - -- -- Street Registered Architect and /or Engineer ___ Employing Plumber's Name 7 . ..... .......... _____ Location and Legal Description Lot Block Subdivision _ ___ -__.. Street and Number where work is to be performed —No 2 State work to be performed and purpose of building (By Floors) _- New Building __ Remodeling_____ ____ Addition__________ Repairs No. of Stories_ Size Septic Tank __--------- __ -_ -- Type of Tank Feet of Drain Tile________ —_____ -__ --Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . — ____________________ _ ___ Size of Soakage Rit Amount of Permit $_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Capacity Gals. Street // • (Signed) - -- — _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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 lic eneed by Miami Shores Village. ( Signed )- Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. % /;� a i (:i 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 be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A inspection fee of $:1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty materials an workmanship. L I in tve PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7 A Job Address 4'6 / /W 5 5/ Tax Folio Legal Description Historically Designated: Yes 4/G> No Owner/Lessee / Tenant 0�� M, .~e-71,6X2 Master Permit # 9 t, f f g 3 g Owner's Address / Phone r3 /5 - 2- 77/ Contracting Co. '/Vi/Ye.- (,) Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC PLUMBING ECHANICAL ROOFING PAVING FENCE &IAN WORK DESCRIPTION ,et PG.4G0" 777/4 /7-4 wI -- - 36-791- 'f GVT Square Ft. Estimated Cost (value) . /0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU.1 PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITFI YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a penrit 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 P, pcjitIGm. 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 doe stated. Signature of owner and/or Condo President Date Signature csrContrac or or Owner - wlder • Date Notary as to Owner and/or Condo President My Conunission Expires: FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing 1 Date Notary as to Contractor or Owner - Builder My Co • O , ` P , eG NOTARY RY P�j MARGARITA MONTIEL * / 1 5 , , � !R °omission wure ', '�Ii a CC797277 7.• . F�� 9\ t Y COMMISSION 7,2002 C.C.F. 0 NOTARY ® BOND Electrical Structural Engineer Permit No {� Date /4 6 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. YE4hAR Owner's Name and Address Size Septic Tank_ — Type of Tank Feet of Drain Tile__ ___ —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _____Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. My C Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Si (Signed). Street_ I Subdivision_ Capacity Gals_ __ __ _ ____ ___ __ Notary Public, State of Florida Registered Architect and /or Engineer --- --- ----------- _____- -- -___ - -- ____ -- Employing Plumber's Name ge '- !ay No._ � _ - - _ __. _-- .------ - -. .._ Street__ Location and Legal Description Lot-_____— ___________________.___ Block Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors )_-__ _________ __. ___ _________ / New Building _- _ -- Remodeling - -- -- ___ --- Addition Repairs __ -_A .______. __.. No. of Stories. - - ' -..... _.___ .... `7 ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oh')igations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by 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. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlmzanship. CLO8ET6 BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS EX e.i A7 /i✓ i Za_ TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No {� Date /4 6 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. YE4hAR Owner's Name and Address Size Septic Tank_ — Type of Tank Feet of Drain Tile__ ___ —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _____Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. My C Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Si (Signed). Street_ I Subdivision_ Capacity Gals_ __ __ _ ____ ___ __ Notary Public, State of Florida Registered Architect and /or Engineer --- --- ----------- _____- -- -___ - -- ____ -- Employing Plumber's Name ge '- !ay No._ � _ - - _ __. _-- .------ - -. .._ Street__ Location and Legal Description Lot-_____— ___________________.___ Block Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors )_-__ _________ __. ___ _________ / New Building _- _ -- Remodeling - -- -- ___ --- Addition Repairs __ -_A .______. __.. No. of Stories. - - ' -..... _.___ .... `7 ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oh')igations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by 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. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlmzanship. 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 .__u l l f , r_ -- No._ 1263 Street N ° E. 93rd St. Registered Architect and /or Employing Plumber's Name ABC SeG_t,erviee No. _..3112 -- Street�I.lal.-- �l - -S Location and Legal Description lLot___ _ .____ _ __.__ —. _ _ _ Block Street and Number where work is to be performed —No 1263 State work to be performed and purpose of building (By Floors) _ _____ _ New Building____.__ -__—__ _ Remodeling_ __ __ ____ Addition. k y Permit No �` c Size Septic Tank _ - _ _— .- _ --- -- Type of Tank Feet of Drain Tffe._.32 °._ReEljg _____ —_ —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well _ _ _ _ _ _— .... -.__ _.—._-_Size of Soakage Pit Amount of Permit $____..- . _____�_ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Capacity Gals (Signed) (Signed). Date November Subdivision Street LE. 93rd St. Repairs X No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by tlie 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. 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 Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS TUBS S LAVA TORIES S6 INK SLOP SINKS LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FI %TURES CONTR. LIST CHECK SEPTIC TANK SEWER comm. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST CHUCK 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 .__u l l f , r_ -- No._ 1263 Street N ° E. 93rd St. Registered Architect and /or Employing Plumber's Name ABC SeG_t,erviee No. _..3112 -- Street�I.lal.-- �l - -S Location and Legal Description lLot___ _ .____ _ __.__ —. _ _ _ Block Street and Number where work is to be performed —No 1263 State work to be performed and purpose of building (By Floors) _ _____ _ New Building____.__ -__—__ _ Remodeling_ __ __ ____ Addition. k y Permit No �` c Size Septic Tank _ - _ _— .- _ --- -- Type of Tank Feet of Drain Tffe._.32 °._ReEljg _____ —_ —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well _ _ _ _ _ _— .... -.__ _.—._-_Size of Soakage Pit Amount of Permit $____..- . _____�_ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Capacity Gals (Signed) (Signed). Date November Subdivision Street LE. 93rd St. Repairs X No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by tlie 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. 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 Master Plumber. 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. Permit No._____ ...... 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�fot., A copy of approved plans and specifications must be kept at building during progress of wor , / • _,. Owner's Name and Address �._ - -_ -� - �' =_ �::____ -- � - -- � �. --- - -.__ No. - - -_ -- — Street___ - - - - - Registered Architect and /or Engines,__—__ Employing Plumber's Name_ j,9 a J , New Building Amount of Permit Q STATE OF FLORIDA, COUNTY OF DADE. NOTE: A re- materials : s / ry� My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , /%1-_ p \ : Location and Legal Description I.ot._.______---- ______ _. _ Block - Street and Number where work is to be performed— No.__ _ State work to be performed and purpose of building (By Floors) Remodeling — ____------ _____ —__ Addition Street___ Subdivision � n -Street Repairs___ No. of Stories Size Septic Tank ..... _____ -- i7;-,., mil___ -Type of Tank__ � .. - � Capacity Gals Feet of Drain Tile - -- -, �� —_,: E st. Feet of Tank or Dram Field from Well Nature of Water Supply: Cky— Well.- --- _ _--- -_----- ___ -- -- —_-_ Size of Soakage Pit (Signed)_ _- -- -- Plumbing Inspector. The undersigned applicant fcr this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be pe forpned under this pen it, as are licensed by Miami Shores Village. // (Signed Master dumber. Notary Public, State of Florida Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, 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. on fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty kmanship. CLOSCra BATH TUDS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR .DRAIN DRINKING FOUNT' NS TOTAL FI %TURES comm. LIST CNECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTQM SW IM•G POOL CONTR. LIST ~! CHECK Permit No._____ ...... 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�fot., A copy of approved plans and specifications must be kept at building during progress of wor , / • _,. Owner's Name and Address �._ - -_ -� - �' =_ �::____ -- � - -- � �. --- - -.__ No. - - -_ -- — Street___ - - - - - Registered Architect and /or Engines,__—__ Employing Plumber's Name_ j,9 a J , New Building Amount of Permit Q STATE OF FLORIDA, COUNTY OF DADE. NOTE: A re- materials : s / ry� My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , /%1-_ p \ : Location and Legal Description I.ot._.______---- ______ _. _ Block - Street and Number where work is to be performed— No.__ _ State work to be performed and purpose of building (By Floors) Remodeling — ____------ _____ —__ Addition Street___ Subdivision � n -Street Repairs___ No. of Stories Size Septic Tank ..... _____ -- i7;-,., mil___ -Type of Tank__ � .. - � Capacity Gals Feet of Drain Tile - -- -, �� —_,: E st. Feet of Tank or Dram Field from Well Nature of Water Supply: Cky— Well.- --- _ _--- -_----- ___ -- -- —_-_ Size of Soakage Pit (Signed)_ _- -- -- Plumbing Inspector. The undersigned applicant fcr this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be pe forpned under this pen it, as are licensed by Miami Shores Village. // (Signed Master dumber. Notary Public, State of Florida Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, 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. on fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty kmanship. Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/9/2005 Applicant: TOMAS SUAREZ Owner: PUIG ALEX JOB ADDRESS: 1263 NE 92 ST Contractor Local Phone: Parcel # 1132050270270 Signed: (INSPECTOR) Contractor's Address: Permit Number: PL2005- 320 Legal Description: BAY LURE PB 44 -63 LOT 16 Permit Status: APPROVED Permit Expiration: 5/1/2006 Construction Value: $2,000.00 Work: PREVIOUS OWNER BUILT A BATHROOM NEW OWNER WANTS TO MAKE IT LEGAL Page 1 of 1 BLK 2 LOT SIZE 75.000 X 125 OR Fees: Description Amount FEE2005 -14331 Building Fee $225.00 FEE2005 -14332 CCF $1.20 FEE2005 -14333 Notary Fee $5.00 FEE2005 -14334 Training and Education Fee $0.40 FEE2005 -14335 Technology Fee $5.70 FEE2005 -14336 Scanning Fee $3.00 Total Fees: $240.30 Total Fees: $240.30 Total Receipts: $0.00 r 09 Pi G (G l2.4-7 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village `►• Building Department BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Owner's Name (Fee Simple Titleholder) I C tt- Owner's Address \ 7 l5 3 (1 City A ,' � t' - rt..S S ~ate - Tenant/Lessee Name 1 " 1 Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name I� Contractor's Address City Qualifier Architect/Engineer's Name (if applicable) $ Value of Work For this Permit 2 • OC 0 Code Enforcement $ Total Fee Now Due $ _ 3D (Continued on opposite side) 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 County I IN- Structural Plan Review. $ St )o veL. Phone # !s O 7 •- Zip A170 Miami -Dade Permit No. Master Permit No. Phone # Phone # State Certificate or Registration No. Certificate of Competency No. Phone # Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees* * * * * * * * * * *;: * * * * * * * * * * *** * * * ** y.. t t; 1{ Mechanical Roofing Zip State Zip Type of Work: ❑Addition ❑Alteration New El Demolition j Describe Work: 1 � � jta2 �c�C' l ( A.k i �C es If �tc ' I � l��r > ,t�,14 t �l (�C r: p Q t �' c..l 2 Lci Submittal Fee $ / Permit Fee $ CCF $ 1 . G O CO /CC Notary $ ). 0. Training/Education Fee $ 0 • 400 Technology Fee $ �. 10 Scanning $ 3. 00 Radon $ Zoning Bond $ 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." Sign: Print: 0 1;i.' MONICA US MY COMMISSION t DO 48399 EXPIRES: October 20, 2009 bi' BondedThruNotaryPubic aer: even insp Notice to Applicant: As a co promise in good faith that a whose property is subject to for the first inspection whic inspection will not be appro Signature The foregoing instru • . s acknowledged before me this day of ,20 ,by who is personally know to me or who has produced A iden NOTARY) BLICf My Commission Expires: APPLICATION APPROVED BY: chc 05/13/03 n to the issuance of a building permit with an estimated value exceeding $2500, the applicant must the notice of commencement and construction lien law brochure will be delivered to the person nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site rrs 7) days after the building permit is issued. In the absence of such posted notice, the ct pn fee will be charged. ( r Signature I Contractor The foregoing instrument was acknowledged before me this day of ,20by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * 4, * * * * * * * * * * * * * * * * * * * ** * * * * * * ye s* s *** . * * ss * ss * *s s * * * * * * * * * * * * * s * * * Plans Examiner Engineer Zoning ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE P00. PIPING LAWN SPRINKLER SYSTE1 GAS RANGE M'ZTER SE1 (GAS) GAS PIPING ADDENDUM IL) bU1 LU1NL rcrtroi. 1 • AN ADii,ICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS E. OBTA WED, THE OWNER • S NOTARIZED SIGNATUR ~. NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL i V 1 f MECHANICAL :TEN UNIT V. FEE ITEW SWITCH OUTLETS UNIT FEE ITEW SPACE HEATERS UNIT FEE ATH TTE LIGHT OUTLETS I CENTRAL HEATING I IDET I RECEPTACLES I A/C (WIND) 1 ISHWASHER 1 SERVICE TEWORARY I A/C (CENTRAL) !ISPOSA! I DRINKING" FOUNTAIN 1 I SERVICE SIZE IN AMPS I DUCT WORK 100R DRAIN SERVICE REPAIR/IETER CHANGE 1 REFRIGERATION ;REASE TRAP I APPLIANCE OUTLETS I PROCESS AND PRESS PIPING NTERCEPTOR I 1 RANGE TOP UNDERGROUND TANKS 1 OVEN I ABOVE GROUND TANKS .AVATORY TRAY I WATER HEATER 1 U.F. PRESSURE VESSELS .`UNDRY S WASHER 1- 1 HP STEAM BOILERS , WER 1 MOTORS OVER 1- 3 f-P ( HOT WATER BOILERS SINK, POT /3 COMP. 1 MOTORS OVER 3- 5 1 MECHANICAL VENTILATION SINK, RESIDENCE 1 MOTORS OVER s 8 IF TRANSPORTING ASSEMBLIES 'INK, SLOP I MOTORS OVER 8- 10 HP I ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET I MOTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMG URINAL 1 MOTORS OVER 2E-100 HP I 1 COOLING TOWERS I I WATER CLOSET 1 MOTORS OVER 100 FP 1 1 VIOLATION I I :I.OIRECT Wk TES I ( 1 A/C WINDOW 1 1 REINSPECT)ON I I WATET-, SUPPLY TO: I 1 AIR CONDITIONERS I I 1 A/C UNIT 1 1 STRIP HEATER I 1 I FIRE SPRINKLER 1 1 GENERATORS TRANSFORMERS 1 1 HEATER -NEW INST I I GENERATORS *TRANSFORMERS HEATER - REPLACE 1 1 GENERATORS TRANSFORMERS I 1 LAWN SPRINKLER -WELL 1 SPECIAL PURPOSE 1 SW I KIM NG POOL ( OUTLETS COM4+ERC I AL i WATER SERVICE 1 SIGN TUBES 1 SEWER CONNECTIONS 1 ,*SIGN TRANSFORMERS C ,• UTILITY-SEWER 1 I SIGN T I W E CLOCK I 1 UTILITY -WATER 1 I FIXTURES SEPTIC TANK 1 ANTENNA 1 RELAY 1 TELEVISION CUTLETS ( 1 DRAINFIELD, 4 TILE/RES. ( VIOLATION PUMP & ABANDON SEPTIC TANK I REINSPECTION l 1 SOAKAGE PIT CU. FT. 1 I 1 CATCH BASIN 1 1 DISCHARGE WELL I DOMESTIC WELL I 1 DRAIN AREA DRAIN � 1 ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE P00. PIPING LAWN SPRINKLER SYSTE1 GAS RANGE M'ZTER SE1 (GAS) GAS PIPING ADDENDUM IL) bU1 LU1NL rcrtroi. 1 • AN ADii,ICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS E. OBTA WED, THE OWNER • S NOTARIZED SIGNATUR ~. NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL i V 1 f MECHANICAL nspection Number: INSP -1808 Inspection Date: 12/1212005 Inspector Levrack, James Owner: PUIG, ALEX Job Address: 1263 92 ST Project: <NONE> Contractor: HOME OWNER Building Department Comments 1263 NE 92 ST FINAL RE- FINISH POOL Friday, December 9, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Pho e: (305)795 -2204 Fax: (305)756 -8972 Miami Shores Village, FL Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Comments Block: Permit Number: PI..2005 -120 Permit Type: Imported Permit Inspection Type: Final Work Classification: Plumbing Phone Number 305 - 807 -1883 Parcel Number 1132050270270 Lot: Passed Failed Correction Needed Page 1 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2005 -120 Printed: 4/18/2005 Applicant: TOMAS SUAREZ Owner: SUAREZ TOMAS JOB ADDRESS: 1263 NE 92 ST Contractor Local Phone: Parcel # 1132050270270 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: Legal Description: BAY LURE PB 44 -63 LOT 16 Permit Status: APPROVED Permit Expiration: 10/9/2005 Construction Value: $1,500.00 Work: REFINISH POOL Page 1 of 1 BLK 2 LOT SIZE 75.000 X 125 OR Fees: Description Amount FEE2005 -4935 Building Fee $160.00 FEE2005 -4936 CCF $1.20 FEE2005 -4937 Notary Fee $5.00 FEE2005 -4938 Training and Education Fee $0.40 FEE2005 -4939 Technology Fee $4.00 FEE2005 -4940 Scanning Fee $3.00 Total Fees: $173.60 Total Fees: $173.60 Total Receipts: $0.00 'APR 1 9 pAip o In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: • Miami Shores Village BUILDING PERMIT APPLICATION FBC 2001 s Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple pitleholderf m ; ;. , -) Phone # _ Owner's Address �' i ��� J1 City /'...; ')1:( '.'' ) State '((_ Zip ')27,01 Tenant /Lessee Name Job Address (where the work is being done) 1 `ZL3 , j6 `12 ,! City _ _ Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address City Qualifier $ Value of Work For this Permit Total Fee Now Due $ (Continued on opposite side) / , 00 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305')1195.2204 Fax: (305) 756.8972 State State Certificate or Registration No. Certificate of Compe. ency No. Architect /Engineer's Name (if applicable) Phone # Permit No. _L % ' # Master Permit No. Phone # Phone # Zip Square Footage Of Work: Type of Work: ['Addition ['Alteration ['New El Repair /Replace ❑ Demolition Describe Work: ***** * * * * ** * * * * * * * * * * * * * * * *, F ees * * * * * * * * * * * * * * * * * * * *** * * * * * * ** / i6 , Submittal Fee $ Permit Fee $ --- CCF $ � v � C /CC Notary $ Training /Education Fee $ ' Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip s . 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: 1 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 inspectio which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be /a prove and a reinspection fee will be charged. Signature chc 05/13/03 My Commission Expires: Owner or Agent APPLICATION APPROVED BY1: Signature who is personally known to me or who has produced The f egoingtinstrument acknowledged before me this ( c. - The foregoing instrument was acknowledged before me this day , 203, by day of , 20 , by who is ersonall c own to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLI NOTARY PUBLIC: Sign: +� ._ -X Sign: Print: Print: Contractor My Commission Expires: ********* ** * ** *** * **** *** ** *********} V * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * *.'** * * ** * * * * * * * * * * * * * ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** -Zd`7` r � k-s 3 Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT 4 (13 eul bein the le al ro owner for the property being g property , Located at: 126 AZ p'l2 5 Legally described as Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),,gnd I have read and understand the following disclosure Statement, which entitles me td work as my own contractor, I further understand that I as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two-family residence or a farm out - building. You may also build or improve a commercial building at a cost of 525,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) Was acknowledged before me this LL By Produced Owner initial of reviewing clerk. The foregoing instrument day of who is personally known to me or who has as identification and who did take an oath. Notary ° _ Coro ( pion '? t 1984 �! - J q!- . 7 "O7 tl tart. !■n1 :Int} Bonditir'