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1268 NE 93 St (7),?F Pewit No Registered Architect and /or Engineer _____ __---- --..... -- -_-- .r___ -_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN';' APPLICATION FOR PLUMBING ;r,miVigT 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 A. t U_ _ _F i r V e y No._ 6 ... ------- ...-- - - -.__ Street N. E. 93rd S t Employing Plumber's Name Rog e Sevtic Ta rd._LC_ =_ i✓ .No._ 2,552. _____ -._ Street__ Location and Legal Description Lot. ____.________— ________ __ Block-- Subdivision. - .__ Street and Number where work is to be performed —No 1268 Street N., ;3. 93rd State work to be performed and purpose of building (By Floors ) ___._ _---------_-_-__ -- New Building __ —. ._.._-- Remodeling_--_- Repairs No. of Stories. . ...................... Sim Septic Tank ..... _____--- •-- • —__ -- Type of Tank. Fest of Drain Tile__ S __f_$ .__Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Natu e of. Water Supply: City —Well. atT Amount of Permit $ L_� (Signed) _ umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor undei the Florida Worlanen'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 zequiml by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are liceread by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 1 (Signed)__ Date 1 01 1159 Capacity Gals. ..... efore 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 $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Master Plumber. CLOSETS BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tu88 U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES cow n. LIOT CHECK r SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•O POOL CONTR. LINT CI{ECK - -- ,?F Pewit No Registered Architect and /or Engineer _____ __---- --..... -- -_-- .r___ -_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN';' APPLICATION FOR PLUMBING ;r,miVigT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address A. t U_ _ _F i r V e y No._ 6 ... ------- ...-- - - -.__ Street N. E. 93rd S t Employing Plumber's Name Rog e Sevtic Ta rd._LC_ =_ i✓ .No._ 2,552. _____ -._ Street__ Location and Legal Description Lot. ____.________— ________ __ Block-- Subdivision. - .__ Street and Number where work is to be performed —No 1268 Street N., ;3. 93rd State work to be performed and purpose of building (By Floors ) ___._ _---------_-_-__ -- New Building __ —. ._.._-- Remodeling_--_- Repairs No. of Stories. . ...................... Sim Septic Tank ..... _____--- •-- • —__ -- Type of Tank. Fest of Drain Tile__ S __f_$ .__Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Natu e of. Water Supply: City —Well. atT Amount of Permit $ L_� (Signed) _ umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor undei the Florida Worlanen'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 zequiml by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are liceread by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 1 (Signed)__ Date 1 01 1159 Capacity Gals. ..... efore 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•necessary by improper notice for inspection, or faulty materials and /or workmanship. Master Plumber. Permit No. . ._�... :�� -% Application is her_bv made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This al plication 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 Flonda, a'1 ord'1 ances of Miami Shores Village and all rules and r .gulaticns of the Building Divisior of Miami Shor• -s Village sha!1 be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at build ng dur ng progress of work. C Owner's Name and Addi ess . _ .. . - -• _ - - _ . No. ___ -.- _ -- _ .. Street Registered Architect and /or Engineer Employing Plumber's Name ._ .----- ._ - -•• - -- - _ __._ _. -____ _.._.._ _ ... _ No._ Street -______ Location and Legal Description Lot_ _. _ ._ _ Block... Subdivision Street and Number where work is to be performed —No .� � '. _ f ` 77 / •_ V._ St eet _......- - - -.._ Stat. work to be performed and purpose of building (By Floors) ---------- • - -. -- N.w _.' Remode.mg .._._ Amount of Permit $ ---,— STATE OF FLORIDA, l m. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition--- -__ - -. _ -•_ - -•_ - -- Repairs Type of Tank_ _ — _ _ _...___...__ _ _....... - -. _ - -. _ Capacity Cals. Size Septic Tank --- ..... _.L r • Feet of Drain .. _ . ! Dist. Feet of Tank or Drain Field from Well_ _...... _...__ _ ... Nature of Water Suppl .; Ctcy; ell .----- .-- __ - - - � .. - :_ �. % _.___.._ ..... � —.Size of Soakage Pit ........... .... -._... (Signed) 7 • (Signed)- Cd ' Date __ 1 / .71 r ` No of Stories.._. / Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he underst ands and accepts hi.; obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled Genera'. Laws of Florida Pennanent Supplement, and hns com- plied with the provisions thereof, and will require similar compliance from all contracfio:s a sub - contractors employed by him in the w :,rk to be per.ormed under this permit; and will post or cause to be posted for inspection on the site of tl.e 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 arc licensed by Miami Shores Village. Master Plumber. Before me, the undersigned aut''ority, a notary public, duly authorized to administer oaths and rake acknowledgments, personally appeare to me well . and who, being by me first duly sworn, upon oath deposes and says that he is th- at the abov; described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat. therein by R} , 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- nspection is made nzcessary b, improper notice for inspection, or bill materials and /or workmanship. CLOSETS OATH T000 SHOWERS LA A. To , 0 SINKS SLOP SINKS LAUNDRY TUBS URINALS CA B ?SIN FLOOR DRAIN DRINKING FOUN, NS G /��' TOTAL FIXTURE: D �, 1 — - - Li T . CH ICK / a .moire... —� � 4..i \ . (I \ 1 � �.. j �.,�% tOAKAOR PIT GREASE TRAP -SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'O POO . SEPTIC TANK SEWER CONN. DRAIN FIELD Corm. LIST CHECK i; Permit No. . ._�... :�� -% Application is her_bv made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This al plication 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 Flonda, a'1 ord'1 ances of Miami Shores Village and all rules and r .gulaticns of the Building Divisior of Miami Shor• -s Village sha!1 be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at build ng dur ng progress of work. C Owner's Name and Addi ess . _ .. . - -• _ - - _ . No. ___ -.- _ -- _ .. Street Registered Architect and /or Engineer Employing Plumber's Name ._ .----- ._ - -•• - -- - _ __._ _. -____ _.._.._ _ ... _ No._ Street -______ Location and Legal Description Lot_ _. _ ._ _ Block... Subdivision Street and Number where work is to be performed —No .� � '. _ f ` 77 / •_ V._ St eet _......- - - -.._ Stat. work to be performed and purpose of building (By Floors) ---------- • - -. -- N.w _.' Remode.mg .._._ Amount of Permit $ ---,— STATE OF FLORIDA, l m. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition--- -__ - -. _ -•_ - -•_ - -- Repairs Type of Tank_ _ — _ _ _...___...__ _ _....... - -. _ - -. _ Capacity Cals. Size Septic Tank --- ..... _.L r • Feet of Drain .. _ . ! Dist. Feet of Tank or Drain Field from Well_ _...... _...__ _ ... Nature of Water Suppl .; Ctcy; ell .----- .-- __ - - - � .. - :_ �. % _.___.._ ..... � —.Size of Soakage Pit ........... .... -._... (Signed) 7 • (Signed)- Cd ' Date __ 1 / .71 r ` No of Stories.._. / Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he underst ands and accepts hi.; obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled Genera'. Laws of Florida Pennanent Supplement, and hns com- plied with the provisions thereof, and will require similar compliance from all contracfio:s a sub - contractors employed by him in the w :,rk to be per.ormed under this permit; and will post or cause to be posted for inspection on the site of tl.e 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 arc licensed by Miami Shores Village. Master Plumber. Before me, the undersigned aut''ority, a notary public, duly authorized to administer oaths and rake acknowledgments, personally appeare to me well . and who, being by me first duly sworn, upon oath deposes and says that he is th- at the abov; described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat. therein by R} , 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- nspection is made nzcessary b, improper notice for inspection, or bill materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner s - Bu li' Building r +l ,: r "r ` " .. Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA DATF " 195 M4. \ PERMIT N? 13360 (I Work to be performed under this Permit Bl. Subdi- vision ee Signed • J \. V CONTRACTOR OR BUILDER BY Contractor's License No ! {}'� } Value of Amt, of r' y Project $ Permit $ y This permit is granted to the contractor or builder med above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved fry the proper municipal authorities. This Permit may b revoked at any time if the work is not done in compliance with such ordinances or if the plans are chaaged authorization. further condition up w ch this permit is granted is the understanding that the contractor or builder named above asfumes the `esp)/nsibil 'for a thor u knowledge of i ord n• and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statemelnS;or s ca• .ns and that a •ume res.',nsibility for work done by his agents, servants or employees. J INSPECTOR In consideration of the issuance to me of this permit I agree tolerform the work covered hereunder in com nce with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, t tements or specifications submitted to the oper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work dose by either, myself, my agent, servant or employee. AUTHOR= Legal Description Address of Building Lot BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building II CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT 'N° 13386 Work to be performed under this Permit Architect Contractor or Builder Bl. Subdi- vision Value of Project $ DATE --' 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all svork done by either, myself, my agent, servant or employee. ^�'� BY AUTHORITY MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. a l .��-- ��.L 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 nod. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address if tsr_+"`r —_ / flay Registered Architect and /or Engineer o`i Plumber's �t I tion an gal No L 2 i l,c, _3Sitreet.. N „,,LtizeA k i, .�. Street and Number where work Is to be performed —No —/� Z f AY t Str State work to be performed and purpose of building (By Floors) _— K / /4.f 4W New Building- - - - -._ — -- .--- ........_.. Remodeling__-__.. Dil Amount of Permit 1_ . ®0 ( S _ Addition. _ Repairs (Signed) " esgz �. .....__._...._ S ubdi ‘124- Size Septic Tank_206 Type of Tank C . � — ._-- .. -. - - -• - - -.- •Capacity . -- Feet of Drain Tile. —Dist Feet of Tank or Drain Field from Well...-.—_ - - -_ -- Nature of Water Supply: City —Well. Size of Soakage Pit No. of Stories Master Plumber. Plumbing Inspec 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 ha. com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort- to h,, performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ notice or notices as err required by the Act. The undersigned agrees to employ only such sub-contractors, to performed .er this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, l COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take admowledgments, 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 be 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 11.00 will be made whom stab mirupeotion la Inede•neoaaaaty by improper notice for impaction, et holly materials and /or wcrloaanahip. CLOSETS BATH Tu•S SHOWERS LAVA• TORIES 115"4" SLOP SINKS LAUNDRY Tuns UR CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N• TOTAL PIIITURas CONTR. LIST CHECK SEPTIC TANK SEWER CONK. DRAIN F IELD SOAKAGE PIT G TRAP SOLAR NEATER DEEP WELL SPRKLR. SYSTEM SIMIM'O POOL CONTR. LIST r -- CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. a l .��-- ��.L 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 nod. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address if tsr_+"`r —_ / flay Registered Architect and /or Engineer o`i Plumber's �t I tion an gal No L 2 i l,c, _3Sitreet.. N „,,LtizeA k i, .�. Street and Number where work Is to be performed —No —/� Z f AY t Str State work to be performed and purpose of building (By Floors) _— K / /4.f 4W New Building- - - - -._ — -- .--- ........_.. Remodeling__-__.. Dil Amount of Permit 1_ . ®0 ( S _ Addition. _ Repairs (Signed) " esgz �. .....__._...._ S ubdi ‘124- Size Septic Tank_206 Type of Tank C . � — ._-- .. -. - - -• - - -.- •Capacity . -- Feet of Drain Tile. —Dist Feet of Tank or Drain Field from Well...-.—_ - - -_ -- Nature of Water Supply: City —Well. Size of Soakage Pit No. of Stories Master Plumber. Plumbing Inspec 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 ha. com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort- to h,, performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ notice or notices as err required by the Act. The undersigned agrees to employ only such sub-contractors, to performed .er this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, l COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take admowledgments, 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 be 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 11.00 will be made whom stab mirupeotion la Inede•neoaaaaty by improper notice for impaction, et holly materials and /or wcrloaanahip. OTV DESCRIPTION PRICE AMOUNT ' REP-Ace 3RoKEN LIDS ON SEPTIC TANK. P(AMP Oi.CT TANK i4ND CLEAN cur DCBRlS FRoM 3oTToM . atfEcK coNNEc rioNs ON, TANK. A5 FER PROPOSI L_ OE 3- 30 -93. PLEASE Jo� � � PAY FROM THIS INVOICE S C� l< B TOTAL ' o 00 — 035 r TAX TOTAL i Great Atlantic Plumbing, Inc. 10770 N.W. South River Drive • Medley, Florida 33178 758-4023 (305) 557 - 3680 MARYBAREARA IV 1 E. 12G6 N,E.93RD STREET MAIM , SHORES, FL . 33138 DATE 4 -5 - q3 INVOICE NO. 1 53801 INSURED 13945 S.W. 140 at. 1 GES A CO LTR 1 ;: 1 f r _0( AAA SOUTH PACIFIC INS 385 WEST 49 ST HIALEAH FLA 33012 MIAMI FLA 33196 PARADISE POOL z5) --SAW THIS IS TO CERTIFY T111 t POLICIES Or INSURANCE LISTED BELOW HAVE BEEN ISSUEDT0THE INSURED NAMED ABOVE FOR THE POLICY PEfIOOINOICATED. NOTWITHSTANDING ANY REfUIREMENT, TERM On CONDITION OF ANY CONTRACT OR Ol HER DOCUMENT WITH RESPECT TO W1IICH nip CERTIFICATE MAY SE ISSUED OR MAY PER I AIN, THE INSURANCE AFTOROEO BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POI JCIF. S. TYPE OF tNSt,t 'JUF GENERAL UABILII -t— _ COAIPREIIENSM IDPLI T AUTOMOBILE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN vim; LA IORM OTHER PREMISE.VfPERAT II'; LINDER1;ROUND EXPLOSION & C'IIl HAZARD PROOUCT$/CO.tPI.TITO OPERATIONS CONTRACTUAL INT)EPENOENT I't 4F)Af r')ILS BROAD FORM PIIOrrkr, DAMAGE PERSONAL INWORY MY AUTO All OWNED M/IIh -: ;rfiv PASS I ALL OWNFn A(I1' I' rat 11 I ISS f Inn(n AI)IIIS NON OWNED AII(aS GARAGE LIAR)I ttY WORKERS' COMPENSATION ANT] EMPLOYERS' LIABILITY POLICY NUMBER GL 005381 DESCRIPTION OF OPEMIKNISILO TIONSNEINCLES!SPECMAL ITEMS MIAMI SHORE BLD ZONING DEPT 10050 N.E. 2 AVE MIAMI FLA 33138 IS UAIF (►.IAbf(Hr') FINIS cenrwpcmi IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONrETIS NO RIGHTS LANAI THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. • COMPANY LETTER s COMPANY ET c c�EARNY D COMPANY E LETTER POOL BUILDING & REPAIR COMPANIES AFFORDING COVERAGE COMPANY A LETTER ^ GRANADA INS CO POLICY EFTECTIYE DATE (MAM)OM') 4/0.9/93 rktk 5/) tif"ti ,ham )7' POLICY EXPIRATION DATE (KOWYYI 04/0993 LIABILITY LIMITS IN THOUSANLU Jfl fl ' c t�CUnntNCE A0OnEOA IIOOIIr 1 000 PROPS Tr OAMAG 000 91 a PO .1000 COM91NE0 PERSONAL INJURY 9oplr ALAN (PER P $ SODLY ER *U11) $ PROPERLY DAMAGE $ 91a COMBINED C0&TBI rED $ STATS/TOW( 1 EACH ACCIDENT) (01SEASE•POLICY LSAT) (DISEASE EACH EMPLOYEE) CERTIFICATE HOLb R ACORO23(818) CANCELLATION IUI /ACORD CORPORATION$ R SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX. PIRATION DATE THEREOF, THE ISSUING COP4PANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO T CERTIFICATE MOLDER NAMED TO THE LEFT; BUT FAILURE TO . • SUCH NOTICE S LL IMPOSE NO OBLIGATION OR UABIUTY Of ANY AUTHORIZES KIND UPON TATIVE A 9 N OR. tAEPREgENTATIVES. tj PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address e • -fax Folio Legal Description Owner / Lessee / Tenant v �% Owner's Address � � _ 3 Phone 21- Contracting Co. —� d Li .J' " 4 Address O 2 (-- ?i � Qualifier , j�1!%��i�' � � -�� �2� SS4� ( � - �' � - � l� � t' State #( /9'u''Municipal # Competency # /(35 Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICA PLUMBI Qj MECHANICAL ROOPING PAVING FENCE SIGN zi WORK DESCRIPTION / /d-C G 4,40,4 2 6 Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: Zoning Building Mechanical Plumbing Master Permit # 3 S/r, e Square Ft. Estimated Cost(value) G WARNI 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 constr ton and zoning. Furthermore, I authorize the above -named contractor to do the work ate. / ` Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner - Builder My Commission Expires: �g�':� :Piy; CHRISTINA PORRAS �., ' MY COMMISSION / CC 282819 * * * * * * * * * * * * * WRNS: WOO, 1907 * it* Banded Tin Nonr1' RAW Unds w1Een FEES: PERMIT RADON C.C.F. G NOTARY TOTAL DUE 1 " APPROVED: Fire Other �l Electrical Zt / /i f Engineering