Loading...
326 NE 92 St (2)BUILDING ❑ ELECTRICAL PLUMBING ❑ ROOFING Owner of Building Legal Description Address of Building Lot ❑ PERMIT N° 14831 ❑ Work to be performed under this Permit Architect Contractor or Builder 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 work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA 11 BL Subdi- vision Value of Project $ DATE Contractor's License No Amt. of Permit $ BY AUTHORITY BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA DATE `s sof 194_& PERMIT Nn' 4496 License No. t` �f3 Work to be performed under this Permit Owner of Building Subdi- vision Legal Lot Bl. Description Address of T Value of Building Project This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described inappli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance ith 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- f J 1 h L A Amt. of Perniit sibility 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 responsibili.for all worke by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING C3 PERMIT 11T° 3616 MIAMI SHORES VILLAGE, FLORIDA Owner of Building Architect Contractor or Builder Legal Lot Description �I Bl Address of Building DATF 195 Contractor's License No. Work to be performed under this Permit Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY e BUILDING ELECTRICAL PLUMBING Owner of Building Lot MIAMI SHORES VILLAGE, FLORIDA DATE 3ERMIT N? 6392 Work to be performed Architect Contractor or Builder Legal Description Address of ; c--) Building t` /Y I I 9 � (41,1. CONTRACTOR OR BUILDS' ti Bl. under this Permit f, t "/ /7 Subdi- vision G Signed: /�' INSPECTOR Contractor's License No. of Amt. of Project Permit This permit is grar to the contractor or b 1 der named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 r drawings or in the or specifications and that he assuches respon- sibility for work done by his agents, servants or employees. �. /% By 194 ° 4 In consideration of the issuance to me of this permit I agree to perforrh the work covered hereunder in compliance with all ordinances and re ns pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shorts VQlle. In accepting this permit I assume responsibility for all work done by, either myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA DATE 194* PERMIT Nn 4254 Work to be performed under this Permit Owner of Building Contractor's License No. r' Architect Contractor or Builder x Legal Lot 131. Subdi- Description vision Address of Value of Amt. of Building Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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. 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 work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY Permit No._?..____—. Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot 1 MI SHORES VId rAGE PLUMBING INSPECTION DEPARTMEi's' APPLICATION FOR PLUMBING " 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. Date Str eet.3 y - f , f_2 eFt - -- - - -- - ---- ] 033 Txtz Subdivision. Block_ Street and Number where work is to be performed —No._ 3 y6 2 Street State work to be performed and purpose of building (By Floors) New Building __ __. Remodeling_____ _ __._ Addition.___ Repairs No. of Stories. Sire Septic Tank Feet of Drain Tile__ Nature of Water Supply: City —Well. Amount of Permit $ 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 bus 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 � rk to be performe • u ' er this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires DD ee Type of Tank 4 �`Dist. Feet of Tank or Drain Field from Well _ Size of Soakage Pit (Signed) _ ( Signed ).___..____. Capacity Gals. Notary Public, State of Florida Mas 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 SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHIZCK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIaT CHECK Permit No._?..____—. Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot 1 MI SHORES VId rAGE PLUMBING INSPECTION DEPARTMEi's' APPLICATION FOR PLUMBING " 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. Date Str eet.3 y - f , f_2 eFt - -- - - -- - ---- ] 033 Txtz Subdivision. Block_ Street and Number where work is to be performed —No._ 3 y6 2 Street State work to be performed and purpose of building (By Floors) New Building __ __. Remodeling_____ _ __._ Addition.___ Repairs No. of Stories. Sire Septic Tank Feet of Drain Tile__ Nature of Water Supply: City —Well. Amount of Permit $ 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 bus 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 � rk to be performe • u ' er this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires DD ee Type of Tank 4 �`Dist. Feet of Tank or Drain Field from Well _ Size of Soakage Pit (Signed) _ ( Signed ).___..____. Capacity Gals. Notary Public, State of Florida Mas 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._ - <w — MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 wort Owner's Name and Address_. 4 ,' � ___,�___ �� / 1 Registered Architect and /or Engineer Employing Plumber's Name New Building Remodeling 0 N o . _ �� Street Street Location and Legal Description Lot___ - '_ Block _____�____�. w Subdivision___% Street and Number where work is to be performed— No._. %_ . _._ / d T __�__ Street State work to be performed and purpose of building (By Floors) Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well. (Signed) /plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligOtions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such °public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. ( Signed) -' • 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. 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. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. IST LIST i /7 I/ . 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._ - <w — MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 wort Owner's Name and Address_. 4 ,' � ___,�___ �� / 1 Registered Architect and /or Engineer Employing Plumber's Name New Building Remodeling 0 N o . _ �� Street Street Location and Legal Description Lot___ - '_ Block _____�____�. w Subdivision___% Street and Number where work is to be performed— No._. %_ . _._ / d T __�__ Street State work to be performed and purpose of building (By Floors) Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well. (Signed) /plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligOtions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such °public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. ( Signed) -' • 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. 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. Permit No. ..__ /Y . Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address_ -. �' /� /' Registered Architect and /or En ' eer_ Employing Plumber's Nam .__ -; Amount of Permit $ STATE OF FLORIDA, f ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. Location and Legal Description Lot_ _.__._. _ _ Block Street and Number where work is to be performed —No a2' State work to be performed and purpose of building (By Floors)_. New Building Remodeling Addition____._______... ____. Repairs. (Signed) Date Street.. No.. 1 - 5 e..?' �� Street.. L Subdivision__ Street _ No. of Stories Size, Septic Tank__ Type of Tank_._ .. Capacity Cals.. ile ,24/ y4 ? Dist. Feet of Tank or Drain Field from Well f' Nature of Water Supply: City —Well — Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and hus 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 pe ormed under this permit, as are licensed by Miami Shores Village. . (Signed)._ x <. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 lac 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 foul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES I SNKS SLOP SINKS LAUNDRY TU88 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURII CONTR. LIST CHECK ___ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WILL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. ..__ /Y . Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address_ -. �' /� /' Registered Architect and /or En ' eer_ Employing Plumber's Nam .__ -; Amount of Permit $ STATE OF FLORIDA, f ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. Location and Legal Description Lot_ _.__._. _ _ Block Street and Number where work is to be performed —No a2' State work to be performed and purpose of building (By Floors)_. New Building Remodeling Addition____._______... ____. Repairs. (Signed) Date Street.. No.. 1 - 5 e..?' �� Street.. L Subdivision__ Street _ No. of Stories Size, Septic Tank__ Type of Tank_._ .. Capacity Cals.. ile ,24/ y4 ? Dist. Feet of Tank or Drain Field from Well f' Nature of Water Supply: City —Well — Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and hus 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 pe ormed under this permit, as are licensed by Miami Shores Village. . (Signed)._ x <. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 lac 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 foul materials and /or workmanship. Permit No._ ,1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buil ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vil age, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /o Engineer 4 , Employing Plumber's Na C t - it - , No y i ' -' Street_`' Location and Legal Description Lot (I lock" �' 1 �. S�ilbdivision Street and Number where work is to be performed —No j , '114 4� S ' e t__ State work to be performed and purpose of building (By°Floors1 -- -r. New Building Remodeling Addition Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. . STATE OF FLORIDA, COUNTY OF DADE. _ (Signed) ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No 3 2. (Signed) Repairs No. of Stories 7 I Date ` My Commission Expires Notary Public, State of Florida Street .) Q 7 mot_ 'tj 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 workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST / ` ` ri yR (/�" CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No._ ,1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buil ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vil age, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /o Engineer 4 , Employing Plumber's Na C t - it - , No y i ' -' Street_`' Location and Legal Description Lot (I lock" �' 1 �. S�ilbdivision Street and Number where work is to be performed —No j , '114 4� S ' e t__ State work to be performed and purpose of building (By°Floors1 -- -r. New Building Remodeling Addition Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. . STATE OF FLORIDA, COUNTY OF DADE. _ (Signed) ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No 3 2. (Signed) Repairs No. of Stories 7 I Date ` My Commission Expires Notary Public, State of Florida Street .) Q 7 mot_ 'tj 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 workmanship. ,c9? Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mianii 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 Mianii Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Lot Block Subdivision Street and Number where work is to be done 9-2 State work to be done and purpose of building (by floors ) Rc?egzz-z c, AT 27 E New Building _Remodeling ddition. To be constructed of- -d��aa .... Kind of foundation. Estimated Total cost of improvements $ MP s - Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor — Disapproved Date._ ( Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Amount of Permit $ Plan Cubage Size of Building Lot But ding Insp /PLANNING BOARD DATE Chairman Member Member Member Member Member Notary Public, State of Florida Owner's Name and Address Registered Architect and,ter""Engineer. Name and address of licensed contractor Location and legal description of lot to be built on e ridZ-I4 no other purpose. Repairs K No. of Stories X. . Roof Covering I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in 'the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontract o on work to be performed under this permit, as are licensed by Miami Shores Village. ri Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that 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 e. Permit No 7 S Date z — Read, Sworn to and Subscribed before me. My Commission Expires Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faul' materials and /or workmanship. t� •)HERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) 3 a A 6 sir_ Legal Description L o7 ' /0 - 03 A e 4 9 Master Owner / Lessee / Tenant � Z ceuiu (VI. Owner's Address Job Address Contracting Qualifier Co. [ F� �, 'f�l Address 7 fOo i sji4-s e SS# rphone State# er e: oyp /3/ Architect /Engineer f Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION - e /ey (4 % 1 o 2/7 - R,,e lc/ Square Ft. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do th wor "t st ted. Signature of Owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: * * * * PERMIT FEE: APPROVED: Competency# Ins. Co. Address Address Address Fire PLUMBING MECHANICAL PAVING FENCE SIGN 49 3 59 Estimated Cost / fao Permit P06-4,-61,2 phone ,$) 22 2 / Tax Folio// �7®p /°f 6q Sig .ture o Date: '�!�(oelY as to contractor Other �yN 9 ' ,y actor or Owner-Builder tary0 ggu -er � S� 'fA OF FLORIDA * Com ssjon * pires *MY COMMISSION EVPJJ ES APRIL*16. 1992 BOPoDEIHRU STEM 011R-ADAMS 8 SWEET Zoning Building E ctrical echanical ( i f n��neering (iM Applicant A- U ` ti r.s�. t \ a c'r7 9 u e Z Permit Number / — 3 C4- 7 3 a � .we 9 PART I - SYSTEM CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL- ------ ---- -- Septic tank or G� Grease aerobic un ! gallons interceptor gallons Septic tank or aerobic unit gallons . Dosing tank gallons Graywater tank gallons Laundry waste tank gallons (e) Fill quality and quantity • STATE OF FLORIDA ._ DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Treatment Tank . Other Requirements: P. ! dZ cz. System design and specifications by Construction authorized by: County Public Health Unit • • HRS-H Form 4014 Feb 05 (Obsolete' previous editlons which meiy not be used) (Stock Humber3744-001-4010-0) Authority: Chapter 381, FS Chapter 10D-6, FAC Note: Completed copies of this form will be provided to. the applicant, installer and the building department AUDIT CONTROL NO. 65 4 46 Minimum Dralntrench OR Minimum Absorption " Size Bed Size Square Feet Square Feet Square Feet Square Feet Square Feet Square Feet Square Feet Square Feet (a) Installation must be in accord with requirements of chapter 10D-6, FAC. (b) A system construction permit is valid for a period of one calendar year from date of issue. (c) Final installation inspection and appr al§ required before the system is covered. (d) Invert of statouttor ���` / to be f benchmark. Invert of stub -out for to be benchmark. Invert of stub -out for to be benchmark. Invert of stub -out for to be benchmark. . (f) Other. 1/ ` Date 0-1( Title Page 1 of 2 Cm. as am air Aar - - - -- PROPERTY OF: Rodriguez, fA�s71. Y,aL'fllt2wt` with, 5tiriieyifor's St . Augustin and Margo, 326 N.E. 92nd Street, A BOUNDARY titiRVFY I hereby certify that the sunny lepre• sented hereon meets Ott minimum technical standards set torlh by the Board of land Surveyors pursu:111t 1u Sec n 472.027. Fla. Similes. There are no e .machments,g40aps.easements app aring on th ' Ai. other tl n as sho hereto. f ,/ F a. Re . tat t'Survel•rn No n._f tC4' Y J . (LEI -1'13T 3 ENGINEERS - LAND SURVEYORS - LAND PLANNERS Offire address: 359 Alcazar Avenue, Coral Gables, rlo:ida 33134 Mailing address: P.O. Box 561131, Miami, Florida 33156 DATE e 2 This property described as: Lot 10 and the West 1 1 of Lot 9, Block 48, AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the Plat thereof, as recorded in Plat Book 10, Page 70 of the Public Records of Dade County, Florida. Note: Underground encroachments and utilities, if any, not located. FLOOD ZONE: X Certified To: Betty Anne Beavers, Attorneys' Title Insurance Fund, Inc., Rodriguez, Augustin and Margo and Oceanmark Bank, A Federal Savings Bank, its successors and /or assigns. 1. s r a e n s d aAvhi 1A,31 DRWG. NO 191 -10175 • 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (32a3)58972 BUILDING 4 ��1 �; Permit No. PERMIT APPLICATION JM4ster Permit No.Zp, , 67 FBC 2001 � a Permit Type (circle): Building Electrical Plumbing ) Mechanical Roofing Owner's Name (Fee Simple Titleholder) P' Phone # � C 32 — 2 3/ Owner's Address ,�� 6 A/. C —, �a � City S E' State _P2- Tenant/Lessee Name Job Address (where the work is being done) •� -cam , City Miami Shores Villa •e County Miami -Dade Zip . 37 3S Is Building Historically Designated YES NO t� Contractor's Company Name A I,Am % L IE _• NP ? 'r�� e . Contractor's Addre s 4/7®® A/4/ 4rf City /6 1 / Qualifier 1tnay & Q o - t—cr) Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Type of Work: Describe Work: Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department State f Zip Phone # Zip oo 33/ State Certificate or Registration No. C' _ Certificate of Competency No. Phone # Square Footage Of Work: ['Addition ['Alteration ❑New Repair /Repla1e ptoN- I s rn - RCMP Cgr wri 1 Cx>> ( &jc L cir neuLJ rci-vniccry) oncil ( Q ci\Ca rAin x rm * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee 5 CCF $ Notary $ Training /Education Fee $ Technology Fee $ Scanning 5 Radon $ Zoning Bond $ Code Enforcement 5 Structural Plan Review. $ CO /CC ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject t attachment. Also, a certified copy of the recorded notice of commencemen&must be posted at the job site for the first inspect'', i u seven (7) days after the building permit is issued. In the absence of s. h posted notice, the inspection will .t b� pro' e an a reinspection fee will be" charged. Signatu Signat 0 ner or Agent " Contractor The foregoi b instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of �� , 20�� , day of �k5 , 2105, by _�� GOL who is p rsonally known to me or who has produced who is personally known to me or who has produced As identification a.. did take an oath. NOTARY P LIC: NOTARY PUBLIC: Sign: .� ��� Sign: L�1 � � � � Print: �? ; !- t, a aY 26 Pu ��� dgNESSA 9. BIOS Print: .,..x. My Commission Expires: * �iiii} r EXPIRES: January 14, 2008 My Commission Expires: * MYCOMMISSIONIDD28132r. "fq P ° Bonded Thm Budget Notary Services y p EXPIRES: January 14, 2003 * * * * * * * * * * * * * * * * * * * ** * * * * * *,�4xa ************, t**, t********** ** * ** * ** * * * * * ** * * * * * * * * * * *;‘,*( dt 4* *Bm0.diaIU&BudgettidawSesists APPLICATION APPROVED BY: Chc 05/13/03 as identification and who did take an oath. Plans Examiner Engineer Zoning Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder Owner's Address d,2 9 . Sr BUILDING PERMIT APPLICATION TBC 2001 Cilyf7` B 3 State Tenant /Lessee Name Qualifier Submittal Fee $ Notary $ Scanning $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Training/Education Fee $ Radon $ imam' snores v silage Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Job Address (where the work is being done) 3 24; /VC City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Permit Fee $ f° Zip 3 Phone # Permit No. P Ie ='' $ ster Permit No. Zip _3 3/ E * *************************,* Fe * *,* * * * * * * * * * * * * it* * * * * * * *,* ** CCF $ CO /CC Technology Fee $ Zoning Bond $ Structural Plan Review. $ Mechanical Roofing Phone #( G 2 - 7A3/ Type of Work: ❑Addition ,Alteration ONew ❑ Repair/Replace ['Demolition Describe Work: � a C- tL.. s 61-1/ Contractor's Company Name C i .5&' /- AftZ AZ 'i ,f Phone # (7e4) — Contractor's Address 6 Z Ma,/, ' C v City Slate Zip 3 / / 7 Afet State Certificate or Registration No.0 _ /_`S) 4 Certificate of Competency No. Architect/Engineer's Name (if applicable) „1342M3 Phone # 0 (S3 qi.fir,2 7 mjb.v $ Value of Work For this Permit Square Footage Of Work: (P,$-D Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted al the job site for the first inspection whici occ s' 'en (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b . �.r. e,i.nd a r inspection fee will be charged. Signat► NOTARY Sign: Print: 0 'r or Agent The foregoing instrument was acknowledged before me this 3 Y day of AWL, 20 ' , by 1I' U who is personally known to me o r My Commission Expires: ..............,.............. APPLICATION APPROVED BY: Chc 05/13/03 * * * * * * * * * * * * * * * * * * * * * * * ** * ** * * * * * * * * * * ** Signature Contractor The foregoing�iinnstnlment was acknowledged before me this 3/ day of /QJ? , 20 ®c ,...•uy7rF■ d ke an oa s pr. duced who is personally known t •:i . � who r,i !r0 • i►1 Jnd W ►d tl ke a► NOTARY PU Si P My Commission Expires: Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE. VESSELS CLOTHES WASHER MOTORS 0- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES - A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS i HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS :SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER • FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING _ c. (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED; THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL A Submittal Fee $ Notary $ Scanning $ Total Fee Now Due $ • $ Value of Work For this Permit e3, Q (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION Master Permit No. � P 4z‘7 FBC 2001 Permit Type (circle): Building ` \ t. Plumbing! Mechanical Roofing Owner's Name (Fee Simple Titleholder)j42b ��� Phone #(3b5) 6 — / Owner's Address 3 .P..4 /v City /f S ( State Tenant/Lessee Name Job Address (whet e the work is being done) 32--6 9'? <5 7 City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO ✓ Code Enforcement $ Structural Plan Review. $ Zip .33/.8.) Phone # Square Footage Of Work: Zip �) �,�,/ / 7 -._ <97 Contractor's Company Name A/c & l r /V _SOVCO /4L 3 Phone # Cat C7 86) (5 Contractor's Address 6' (j 7 M f/lf City n(ii7X State Zip T w5L7 Qualifier Niy NC- -- DSO/ Stale Certificate or Registration No. �rC_ /5Zo &// Certificate of Competency No. Architect/Engineer's Name (if applicable) yx i'1fi)n( Phone #(3 t.,J8 3 -- 7 Type of Work: ['Addition ►1 ' iteration New ❑ Repair /Replace ❑ Demolition Describe Work: C4 1, 4—h-(:3./ I - >4DA) a',A* S - 7,eTirx--■_ ,E/ A.e, aiv? kS Nom- e- )6 yv 154 * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ CCF $ CO /CC Training /Education Fee $ Technology Fee $ Radon $ Zoning yo &f i' 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 COMMENCEM ENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection whit occurs even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no . • -o . 'ov i a % a r nspection fee will be charged. Signal ji/ /!/%'/ L� -2 Signature Contractor The foregoing instrument was acknowledged efore me this 3/ The foregoing instrument was acknowledged before me this day of 20 *, by IJt,C Olteitr, , day of f1/44f...ciff-- , 20 T by � / eki who is personally known to me or who has produced As identification and who did take an oath. Sign: Print: My Commission E * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * ** * * * * * * * * * * ** **** * * * * * * * * * * * * * * * **. * * * * * * * * * * * * * APPLICATION APPROVED BY: Chc 05/13/03 Owner or Agent NOTARY PUBLIC: who is personally known to nee or who has produced as identification and who did take an oath. Plans Examiner Engineer Zoning