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991 NE 93 St (8)BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical City N t 1 •1 State + C.. Miami Shores Village EC TI E Building Department 1 A,PR a 7 200 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 lumbin Owner's Name (Fee Simple Titleholder) R ( C J E(_., L) E)) Phone # Owner's Address C i`t 1 I` • a,- cc% S'f Permit No. i� 0°04- 113 Master Permit No 7c04— 47C, Mechanical Roofing 355.444 eR6-1-- Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) 9 C r l se. q.3 S4 - Cit )4, Miami Shores Village County .x Miami -Dade Zip f3- f 3 Is Building Historically Designated YES NO Y Contractor's Company Name Ao yVa l mimt::k \DVS Phone # 2 '6' J* 6928 Contractor's Address / % l f ?'fD'4 ,z,j City '('Ci7 State /. Zip .3 $ 94 if cPy (1.A Qualifier Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition ['Alteration , New ❑ Repair/Replace ❑ Demolition Describe Work: & CL) a �. r oo L • 7 1�3rn�1 ■ c0 \5 Submittal Fee $ , CO Permit Fee $ Total Fee Now Due $ \ d (Continued on opposite side) Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * / * * * * * ** CCF$ , ( i Notary $ Training/Education Fee $ A t� Technology Fee $ 1 Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ CO /CC d� C� Bonding Company's Name (if applicable) Bonding Company's Address - • + • City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Chc 12/15/03 My Commission Expires: Signature State Certificate or Registration No. Certificate of Competency No. ' APPLICATION APPROVED BY: 10( 6 Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 5 day of , 20 , by , day of ~ 1 , 20 OA, by y_11 who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: v-» A Print: Print: (Certificate of Competency Holder) ontractor ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -113 Printed: 6/9/2004 Applicant: JOHN MICHEAL WEBER Owner: WEBER JOHN MICHEAL JOB ADDRESS: 991 NE 93 ST Contractor THE CREW Local Phone: 754 -234 -1336 Parcel # 1132060350050 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: 650 CARRINGTON DR. Page 1 of 1 Legal Description: MAGEE & HAWKINS SUB PB 51 -5 LOT 5 & E12FT OF LOT 6 LOT SIZE IRREGULAR Fees: Description Amount FEE2004 -5661 FEE2004 -5807 Building Fee $120.00 FEE2004 -5808 CCF $0.60 FEE2004 -5809 Training and Education Fee $0.20 FEE2004 -5810 Technology Fee $1.80 Total Fees: $122.60 Total Fees: $122.60 Total Receipts: 0 ^V0 — os\c Permit Status: APPROVED Permit Expiration: 10/4/2004 Construction Value: $600.00 Work: NEW POOL PLUMBING WORK 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: BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description. Address of Building n 11 LJ Work to be performed under this Permit Aleramie CONTRACTOR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT B Signed. 12546 Subdi- vision INSPECTOR DATF Contractor's License No Amt. of Permit Value of t: i f i 1 '"t+ j ,✓' ., Project $ i 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 Ony 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. 4t114"`.k.. BY ` ANY BY AUTHORITY >l 1 195 In consideration of the issuance to me of this permit I agree to ` erf the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, state nts or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all rkk a by either, myself, my agent, servant or employee. , MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. 1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othi 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 � A - 3 N. No ' _ = " = 2 No Street Registered Architect and /or Engineer Employing Plumber's Name_ _.. Location and Legal Description Lot______ ... Permit No State work to be performed and purpose of building (By Floors) New Building -- Remodeling Amount of Permit S. STATE OF FLORIDA, } u. COUNTY OF DADE. My Conunission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ��1 `�_.__ ?_���d,l -__— - - -_ No._ _ ._ f / _--- . - - -__ Street-4/ Z p' Registered Architect and /or Engineer._ // --- -- - -__ _ _- -_ - - -- ______--------_-----_--------.-------_-__-- Employing Plumber's Name_.__�L_f/__s_ Cam_ ' _ __ _ - -__ No. _ L 727 Street-,,.G!/ Location and Legal Description Lot Block Subdivision- ____,_____._..___ ...... Street and Number where work is to be performed -No -' 9 / � __�r ..... _.___...... _. Addition._______.______ ______ Repairs No. of Stories.... ......... ...... Size Septic Tank ..... ____ _- __._________________.._______ -Type of Tank Feet of Drain Tile. ____ Feet of Tank or Drain Field from Well Nature of Water Supply: City-Well. _—___.Size of Soakage Pit (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 5968, Compiled General Laws of Florida Pennanent 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. Date e No._- ..... ---------- - - - -__ Street Subdivision _ -Street - ---•` Date Capacity Gals 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- 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 SHOWER! LAVA. TORIES SINKS NKS SLOP SINKS LAUNDRY TUBS URINALS R INALS 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 SPRKLR. SWIM'G POOL }� - I7� CONTR. LOT 1 " � if�I �,/ / W J ELLLL �� � SYSTEM G v"� - -- CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. 1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othi 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 � A - 3 N. No ' _ = " = 2 No Street Registered Architect and /or Engineer Employing Plumber's Name_ _.. Location and Legal Description Lot______ ... Permit No State work to be performed and purpose of building (By Floors) New Building -- Remodeling Amount of Permit S. STATE OF FLORIDA, } u. COUNTY OF DADE. My Conunission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ��1 `�_.__ ?_���d,l -__— - - -_ No._ _ ._ f / _--- . - - -__ Street-4/ Z p' Registered Architect and /or Engineer._ // --- -- - -__ _ _- -_ - - -- ______--------_-----_--------.-------_-__-- Employing Plumber's Name_.__�L_f/__s_ Cam_ ' _ __ _ - -__ No. _ L 727 Street-,,.G!/ Location and Legal Description Lot Block Subdivision- ____,_____._..___ ...... Street and Number where work is to be performed -No -' 9 / � __�r ..... _.___...... _. Addition._______.______ ______ Repairs No. of Stories.... ......... ...... Size Septic Tank ..... ____ _- __._________________.._______ -Type of Tank Feet of Drain Tile. ____ Feet of Tank or Drain Field from Well Nature of Water Supply: City-Well. _—___.Size of Soakage Pit (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 5968, Compiled General Laws of Florida Pennanent 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. Date e No._- ..... ---------- - - - -__ Street Subdivision _ -Street - ---•` Date Capacity Gals 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- 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. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or oth,'i 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 Enginee Employing Plumbers Name w • e • �,� • t Location and Legal Description Lot___ ock ____________ 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 Size Septic Tank Feet of Drain Tile Amount of Permit $ Nature of Water Supply: Wall /% The undersigned applicant for this building under the Florida Workmen's Compensation Ac plied with the provisions thereof, and will req performed under this permit; and will post or required by the Act. The undersigned agree licensed by Miami Shores Village. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No No 2 Y `' Type of Tank_ _ C _ _Di Feet of Tank or Drain Field from elL __ (Signed)_ ermit does hereby certify that he under being Section 5968, Compiled General e similar compliance from all contractors use to be posted for inspection on the si to employ only such sub- contractors, My Commission Expires (Signed) __,e __Street Date 7 9 / ak ge Pit Street r r = , Street r _._C� �� .� Subdivision acity Gals Notary Public, State of Florida in l No. of Stories Plum . ing ands and accepts his obligations as an employ r of labor aws of Florida Permanent Supplement, an has com- r sub - contractors employed by him in the work to be of the work such public notice or notices as are work to be performed under this permit, as are 2 f �:% Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. 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 fat' therein by him stated are true. or. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul materials and /or workmanship. r CLOSETS BATH TUBS SHOWERS LAVA- TORIES NKS SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT' NS d! L ,-✓ t /5. Y ' �7 C P •- (' '''. y y/ J7 / TOTAL FIXTURE: - - CONTR. " e Zs / '1S 2P--- CHECK 3 25 / ® SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL s � i 6V t✓1y ,,,/ (', CONTR. LIST / / �L� 12 Az So /co CHECK / *- Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or oth,'i 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 Enginee Employing Plumbers Name w • e • �,� • t Location and Legal Description Lot___ ock ____________ 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 Size Septic Tank Feet of Drain Tile Amount of Permit $ Nature of Water Supply: Wall /% The undersigned applicant for this building under the Florida Workmen's Compensation Ac plied with the provisions thereof, and will req performed under this permit; and will post or required by the Act. The undersigned agree licensed by Miami Shores Village. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No No 2 Y `' Type of Tank_ _ C _ _Di Feet of Tank or Drain Field from elL __ (Signed)_ ermit does hereby certify that he under being Section 5968, Compiled General e similar compliance from all contractors use to be posted for inspection on the si to employ only such sub- contractors, My Commission Expires (Signed) __,e __Street Date 7 9 / ak ge Pit Street r r = , Street r _._C� �� .� Subdivision acity Gals Notary Public, State of Florida in l No. of Stories Plum . ing ands and accepts his obligations as an employ r of labor aws of Florida Permanent Supplement, an has com- r sub - contractors employed by him in the work to be of the work such public notice or notices as are work to be performed under this permit, as are 2 f �:% Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. 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 fat' therein by him stated are true. or. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul materials and /or workmanship. r Permit No. 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 othe] 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. 1 Owner's Name and Address 1 ‘ ' � = --' No Street Registered Architect and /or Engineer r� Employing Plumber's Name_____'' ' Y ! c4- ' ' 1�- No Street Location and Legal Description Lot- .._______ _____________ - __ - -._._ _____ -- Block_ -- _ ------ ____ -- Subdivision Street and Number where work is to be performed —No Isq 0 .f - Street 9 State work to be performed and purpose of building (By Floors)... New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ Nature of Water Supply: City —Well ( Signed)._ Size Septic Tank `" Type of Tank__ Feet of Drain Tile 0 �a Dist. Feet of Tank or Drain Field from WeIL Size of Soakage Pit Capacity Gals ( Signed) _ ____� - C (.J 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 Pennanent 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 an licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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 fat 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 faul materials and /or workmanship. GLOSSY! BATH TUBS SHOWERS LAVA- TORIES S SINKS SLOP SINKS LAUNDRY Tune U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURE? 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 I, A O A 0 Permit No. 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 othe] 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. 1 Owner's Name and Address 1 ‘ ' � = --' No Street Registered Architect and /or Engineer r� Employing Plumber's Name_____'' ' Y ! c4- ' ' 1�- No Street Location and Legal Description Lot- .._______ _____________ - __ - -._._ _____ -- Block_ -- _ ------ ____ -- Subdivision Street and Number where work is to be performed —No Isq 0 .f - Street 9 State work to be performed and purpose of building (By Floors)... New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ Nature of Water Supply: City —Well ( Signed)._ Size Septic Tank `" Type of Tank__ Feet of Drain Tile 0 �a Dist. Feet of Tank or Drain Field from WeIL Size of Soakage Pit Capacity Gals ( Signed) _ ____� - C (.J 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 Pennanent 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 an licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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 fat 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 faul materials and /or workmanship. Bonding Company's Name (if applicable) Bonding Company's Address • 4 City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 5 day of , 20 _ , by day of - 1 , 20 DA, by a) who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: • AR C 6TAT �C,II fr- COMMISSION M Commission Expires: My Commission : NO. DD003449 x ��'OMMiaSI�?��1 �XI'. FE. 21,2005 ******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **o . * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 NOTARY PUBLIC: Sign: Print: ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address G l e 't ( /'J. City tit ld0 1 c.tic ce State Tenant/Lessee Name Phone # Job Address (where the work is being done) City `"� Miami Shores Village Is Building Historically Designated YES $ Value of Work For this Permit Type of Work: ❑ Addition Describe Work: foe_) — c ?c7:,__sk. \ co \.5 Code Enforcement $ Total Fee Now Due $ \ r4 6 (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 / C L E/1 Phone # 1 ? 4. 01 t + ' . FL Electrical County >< Miami -Dade Zip ' t ? g NO ')Z Mechanical Zip 5 1 ; g' i i Dr. 11 ., Permit No f 0-oo4 113 Master Permit No ?2cQ4— 47C-1 Contractor's Company Name F4.-e �17/Cc P l/yl7,� *S�'VJ Phone # 2 .g"' � 2 p Contractor's Address ' ( l 9 , / (/J , '4', »- d,2. /7. Cit Pv / L c([.! < State Zip . ? 9j? Qualifier 4 (P xLibt Architect/Engineer's Name (if applicable) Phone # ❑Alteration New =� I g,L5.S t CA Square Footage Of Work: Roofing ❑ Repair/Replace ❑ Demolition Vion110ir * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ , CO Permit Fee $ ` 6\ 0 , CCF $ r Notary $ Training/Education Fee $ , A 0 Technology Fee $ Scanning $ Radon $ Zoning Bond $ Structural Plan Review. $ CO /CC d? BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE, FLORIDA.. $4"4° El DATE / "" 195 PERMIT IT? 12734 11 CONTRACTOR OR BUILDER Wgrk to be performed under this Perini Al I :I S1 y 1 A ie 4104 OOP This permit is gran to the contractor or builde named above to co herefor in strict compliance with all ordinances pertain g thereto and wit drawings, statements or specifications that may have been submitted to d time if the work is not done in compliance with such ordinances or if the granted is the understanding that the contractor or builder named above pertaining to the work covered hereby whether shown on tht'p done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to per pertaining thereto and in strict conformity with the plans, drawings, statem In accepting this permit I assume responsibility for all ;work done by eith 7 BY • ontractoi s cense No Amt. of Permit $ tru the building or to install the equipment or device described in the appli nderstanding that t work will be performed in compliance with any plans, ed by the proper nicipal authorities. This Permit may be revoked at any anged without a orization. A further condition upon which this permit is e responsibility r a thorough knowledge of the ordinances and regulations 'n the statem or specifications and that he assumes responsibility for work 401" "I N' . 1 4 1 111"4. " 1 ""wokosvAli r r . INSPECTOR rm the work covered hereunder in compliance with ordinances and re . lations is or specifications submitted to the proper auth es of Miami Shores illage. myself, my agent, servant or, employee. AUTHORITY Or