MECHANICALOwner/Lessee / Tenant fl,,e < ?� /v
Qualifier
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date (9/j X96 Job Address /?01) "V ,T Tax Folio
Legal Description L Historically Designated: Yes
Owner's Address �.y/p /� y�c1r ��.aa /� /sum/ Phone
Contracting Co. A, fl' z ,42R vp /P /a v/ , Address ' y/ / /7
oDOEfzr j2F,Un
State # e a ./ 3 0? Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION r' f,4 /✓', D ra T ,3 AV /2 eon oiT/ .v/ve (✓e/7 ,L / Poo`. / ft
C T✓ ✓/o .x' T/.ts -// � ,a� n, - / 4 A -3 Ai...) hf /.i'/9P- /a fiAac l� iQr z /.u� //ao Dpi, 37V ffe/✓T
Square Ft. Estimated Cost (value) // 4' p/ vo
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate d that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the abov ame t contractor to do th wgrk stated.
/ i , /
owner and/or cy . -o President Date
���07'�.RY S��►l.
Sign
Notary as
My Co
APPROVED:
Zoning
Mechanical
o OvROMititbd9&&211 ° �$
, ION EXP. NOV. 8,1996
FEES: PERMIT Ail& RADON
Date
SS# Phone AE
e _-
Notary as to Contractor or Owner - Builder Date
My Conunission Expir •
Master Permit #
Signature of Contractor or Owner- Builder Date
No
1
C.C.F. NOTARY TOTAL DUE
g- .7e
OFFICIAL NOTARY
L.INiD!.FGt;:
NOTARY PUBLIC RI.IA
CON "_..L.T.n:
2'')%9c7
Building Electrical
Plumbing Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING I
/a k.
DISHWASHER
RECEPTACLES
A/C (WIN))
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)# o /r72, r g /,
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 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 Co*.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTCRS 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 HP .
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
_
AIR CORD I T I ONERS
7ne5 ` IIfyi A
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
_ GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
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 & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
.
CATCH BASIN
.
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
?COL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
3AS PIPING
1
' ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Remarks
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement or Inc plans and specifications herewith submitted for the build •
inc 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 the work.
Date...tZ.L _ ...�.._._.__._�_..._.__..._.... ,19.21
Gavots s Name and Address .., CAO./aG 5F d.F.__.. l49.11/ _ No..? yDl.._.._ . Street. .l'r/bfeS/r...,,5...1/D.
Registered Architect and /or Engineer .,,s. ell ••....•!.....H!!.....•.t...... e...e,.
Name and address of licensed contractor ....ogt. X.41/.1. ass 2l ...�T.....,�4D.,CGX eedt
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done /;0‘0. �.7 ......_.....�.._.. _._ �._.....__
State work to be done and purpose of building (by floors). � 8.4 / ...,t??
5 / , 7 . P I X . . . . f 4 . < 9 . r e a ° R...C' 2 - 04 /FA 4 4 . T x . 0 . ° - 1 1 . . / . A t . o . .. J # — 3... r.. F ... 6 9r 1.4
. and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S.•- .hei..ii�./a &.P Amount of Permit S.
Zone cubage required .Plan Cubage
Distance .to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
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 ‘Vorkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied ssith 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 cruse to be posted for inspection on the site of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such su acto ys, on work to performed under this
pcnnit, as are licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, rsigne• au)ktojrity, 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 true.
Permit No
Disapproved
(Signed)
ss.
Date
Notary Public, State
Building Inspector My Commission Expires
Chairman
Member
Member _.....__....._..._._ ...._
Council Approved Date
Date Rea worn to and Su
PLANNING BOARD DATE
Mcmbcr
Member
Member
Disapproved
i ..t.J........... 'i
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the I'LrnniNg Board.
A re fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice
materials and /or workmanship.
re me.
ICIAL NOTARY SEAL
CARMEN M LOPES
I FARS`fi'UBtTe STATE O FCORIDA
COMMISSION NO. CC288096
MY COMMISSION EXP. UNE 26,1997
Date
has been obtained from
for inspection or faulty
7.
8.
9.
Must file if job valuation exceeds $ 2,500.00 in labor and material and must be posted prior to jobs commencin.
Must be filed at: 44 West Flagler Street, 8th Floor, Miami, Florida
NOTICE OF COMMENCEMENT
TAX FOLIO NUMBER:
PERMIT NUMBER:
STATE OF FLORIDA
COUNTY OF DADE
THE UNDERSIGNED h ¢y gives notice that improvements will be made to certain real property, and in accordance with Chapter
713, Florida Statutes, the following information in provided in this Notice of Commencement.
1. Legal description of property and street address: 9 yo 1 Rath-rue, 1310d, kn. , i I .
2. Description of improvement
pa. /# //'
3. Owner(s) name and address: De//1Jjoe.,- SE of 71j /.9"/ 94/D/ /scAti,./.6 vo. fit,(,/
Interest in property:
Name and address of fee simple titleholder.
4. Contractor's name and address: COvIGrr - an - 0 - ice
.517/ acdvrran 5J-• ) (ollt0o0 c Jf
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address: 1J I A--
Sworn to and
day of
Amount of bond :: $
6. Lender's name and address:
S /GNA
6 6
Print Owner's Name:
scribed before me on this
19 ,
taken
14
w mass .i v
P.2 me tit 4 /.1.►r Co4,2 Prinncyi UkIfc
r►� /rim I 5110i71 5 U
kOrt
Persons within the state of Florida designed by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address: ,t) / i
In addition to himself, Owner designates the following person(s) to receive a copy of a Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes,
Name and address:
Expiration date of this Notice of Commencement (the expiration date is one (1) year from the date of recording un less
a different date is spe
• OF OWNER
•
roe
ersonai :i: TisfRY s
N
afly!>BLIC STs
COMMIS':ION NO. CCZaith not
CO
IVf ISSION NOV. 8 1996
r
•
OAYL OE FLORIDA, COU(' 5r' OF DADE
NO c3`7 C( :i°!?V Ghat 673 !3 ruo p of 4ho 00
e.E1 I:c= fn $:�a p461co of
, AFB. 19
nd crd o; ;:c!CI ScoI.
q TC q ,1'fCircu'tan-0CountyCou 1.
.Sasc. ob LUG A '1
Prepared by: ri 1iphce, (4lapMRN
Address: 5 80 of mills/ i-
..1
mfofffVs ATE OF FLORIDA
COMMISSION NO. CC241145
MY COMMISSION DIP. NOV. 8,1996
Public:
a..
Nota
BUILDING
ELECTRICAL
PLUMBING
ROOFING
1)
MIAMI SHORES tc.LAGE. FLORIDA
Owner of
Building k:
Architect
Contractor
or Builder
:e..
0
❑ DATE '4 r 3_- -195
❑ PERMIT 111? 3564 Contractors ,
❑ License No.
0., Work to be perfcned under this Permit
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
B1
BY
subdi-
vision
Talue of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct tb building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the unerstanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approvd 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 Ganged without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes th3 responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or h the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: ,.„, -, -- - I' .._10. ` ----
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered Zunder 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 assu=re responsibility for all work done by either, myself, my agent, servant or employee.
.7
AUTHORITY e *Mk'
M AM S ;! ® REM V LLA E
BUILDING INSPECTION DEPARTMENT
APPLOICATOON FE3 SLOL®0NO FERMOT
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 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 the work.
Date..._ O)- i.2..___..._ � ,19 Z5
Owner's Name and Address
1_ a -, _ e _ _. No. 1 fir. street__ -- 0 4'CC f/' / ?.
-- .......
Registered Architect and /or )~ngineer
Name and address of licensed contractor. .I,1. ±4 ....B.E..,cQ ).Z4'Q/ 4�';. 3heel .. :>c p :,. /CO 5(„u7,9
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)..ReV Zee
Disapproved _-
( Signed)
Date.
Bui • ° g Inspector
New Building Remodeling Addition Repairs
13 MIA wjtl 3 - fa ' Ca I e - - l _1 s ��e ct . � ' . /D k' v.� (-).0
,
hect V C d w S' G r �eGGL Q I. in o v r-`1 ,,,,✓ °" rd for o o
r purpo
No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $..__ ?op. w Amount of Permit $ 6 o0
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit s�ubbymiit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to i Set! 7e . :.4 -ge- 'W/9/ _ l ) F// 33/
The undersigned applicant for this building pennit 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 Sup {dement,
and has complied with the provisions thereof, and will require similar compliance from all contract.rs or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspectio th a of th- R.rk such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontract to ; performed under this
permit, as are licensed by Miami Shores Village.
Remarks._ (Signed) _LA/
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No._______ u__ Date 4 Qs Read, Sworn to and Subscribed before me.
. me well known,
Notary Public, State of Florida
My Commission Expires
PL NNING BOARD DATE
Chairman /! Member
Member Member
Member Member
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 fao't
materials and /or workmanship.
e,'
Street and Number where work is to be done
State work to be done and purpose of buildin (by floors)
STATE OF FLORIDA, I
COUNTY OF DADE. ss •
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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 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 the work.
Owner's Name and Address IJi V 3 - c-: L_ ` C^0 D w) No.j ') &
Registered Architect and /or Engineer.. 4 J » / 6 -
Name and address of licensed contractor. -.. J ll -G_ ' G- a o c,''' ' � J , r ( —A ��
1
Location and legal description of lot to be built on:
Lot Block Subdivision
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
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 pennit 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. /
Remarks (Signed)
v
Date , 19
9
Street
7 //(/;, ;
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 true, ;
Read, Sworn to and Subscribed before me.
Permit No +_ � ' ' 1 Date
Disapproved r , Date
q \ \f Notary Public, State of Florida
( Signed) .... .. -> - -= = , r ------- \`
Building Inspector - My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.