80 NE 94 St (9)Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/9/2002
Applicant: AUGUST
Owner: WOLFE
JOB ADDRESS: 80
Contractor ALEMAN PABLO
Local Phone: 308 - 681 -5788
Parcel # 1132060130300
Permit Status: Permit Expiration: 3/8/2003
Work: INSTALL WELL FOR SPRINKLER SYSTEM
\ Signe
Signed
NE 94 .
Plumbing Permit
Permit Number: PL2002 -237
WOLFE
AUGUST
ST
Contractor's Address: 1405 NW 121 ST
Construction Value: $300.00
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 & E1/2 OF LOT 3 BLK 3 LOT
00
Total Fees: $0:90
Total Receipts: $0.00
1 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
O
Q 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 conditiqn 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 pe aining 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 em loyees.
(INSPECTOR) BY:
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.
(Contractor or Builder) BY:
i"
■IC 7777707_717CCOS =7772 7=337,73=i 17133337.777177, =I_ QC 7:0:1=0:137i
PAY
TO THE
ORDER OF
PABLO ALEMAN WELL DRILLING
1405 N.W. 121st St. 681 -5788
Miami, FL 33167
Firs Union National Bank
N ® firstunion.com
Org. 003 R/T 067006432
FOR / c- 3O0
PABLO ALEMAN WELL DRILLING
1405 N.W. 121st SE 681 -5788
Miami, FL 33167
PAY rThM,
TO THE
ORDER OF
S EE
First Union National Bank
® firstunion.com
Org. 003 R/T 067006432
POO 58 7 211' 1 : 0 6 7 0 0 6 4 3 2 1 : 2 / 6 6 5 0 3 1 4 0 7 / 9 1 4 1 0
FOR
0005863ii' 1:06 70064 3 2i:2L6650340 ?L9410
/J
/9--- -7,
-D1- DATE
8 r
DOLLARS _•
PABLO ALEMAN WELL DRILLING
PABLO ALEMAN WELL DRILLING
$:90 --
5872
63- 643/670
BRANCH 13093
- 5863
63- 643/670
BRANCH 13093
DATE
NP
$ .300
.00
DOLLARS r "•' " "'
e.a.
CONTRACTOR
New Construction
Name 63 / L o 4 /1 6-' 6'V l
}`
License No. �y
19 ev , 3 913
‘.....,e, �/ "t
Address
.. 0 ! c ;IV- S'
"4/1- / g- t
t=( 33
Telephone 6W ��7g� F
/
5 /7/` f •.. 7 g '
C• J
Qualifier Name
f to
R '
PROPERTY OWNER
4--
New Construction
Name A V s • W o IT t
Address
80 N E Tr b-t
(v Mat $hat F L 3313
Home Telephone
30S 8 0840
�
Business Telephone 30 S a g7_ c A 12 x (Z7
Fax 2 8t6 -°- Z 8t F 28
ENGINEER
New Construction
Enclosure
,
Name
Repair
Alteration Interior
e
R '
License No.
Relocation of Structure
Shell Only
,
Foundation Only
Address _.
'
•
•
Add'l Detachment
Telephone
Other
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Job Address:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
80 N 9,1 ( j?(-
Address Apt.
Folio Number I L -320G-013-0300
Lots 3 Block 3
PB IO PG 70
Subdivision
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
(1lrF}mt korEs P1.
City State
PERMIT APPLICATION
Linear Feet
Base Floor Elev.
3315$
Zip
Descri Lion of Work J NS'64 it WO (I 'NC
6 CI kl£r S c - LE
Zoning
Square Feet Units• Floors
Value of Work SO 0 ' d Bldg Value
Tax Assessed/Appraised Value
Flood Zone X
Page 2
Il\IPORTA NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Maragement1J BRM) and/ortMiathi - Dade Water and' Sewer Depa tment (ME WASD) approval is required:fof applications- involving sewers.
1.
AFFIDAVIT - Please read carefully.
_ wry •.
Application is hereby made to obtain a permit ter do -work and installation as indicated. I, the OWNER of'the•property, certify that all
work will be performed to meet the standards of all taws regulatin& cpnstiuction in this jurisdiction. I understand•tha1 ge
sepgrate rp Its
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, IIRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I.am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
ST' . 0 - ; . 6 •. • • t UNTY OF MIAMI -DADE
1111/ t
Sigat • wner
na
Print Nam J S—
'16 T'c, %7'
F. GUARDIA
ISSION ,# DD 091884
S ei1 ,2006
Notary Public Underwriters
Signature of No
SEAL:
day glidayoffelt611
STATE OF FLORIDA, CO UN Y OF MIAMI -DADS
Signature of Contractor / Qualifier
Print Name
Signature o
SEAL:
Personally known OR, Produced Identification Personally •
Type of Identification Produced: Fl- DC. to 4 to--O (8 - b3' 3 CO- b
•
Sw to and .scribed be . e me this day of.- ft / CHIC
PERMIT APPLICATION
ERTO F. GUARDIA
OMMISSION,# DD 091884 l'
EXPIRES: June 11; 203 �7 ? -
t'scnded Thru Notary Public Underwriters
{
ORArOused4denti atiOn, o
Type of IdentificationPrxtfeed: -. Y r • r _ -. 5:
: u
ELECTRICAL
TVPE,
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TV
Outlet, Appliance
QTY.
'I'VI'E
Service Repair
QTY.
A/C Central 1 -3.Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
IVIECHANICAL
T1'1'E
Minimum Fee
QTY.
'TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTV.
TYPE
Drains, Roof
QTV.
TYPE
Miscellaneous Fixture
()Ty.
'TYPE
Soakage Pit
QT1'.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
z
Well, Supply Atdrfe
1
Page 3
-/
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
[7" . ' 7F1 - 44T , ' <"TrEE f IVE t 7 gs ke'x 3 "'
Page 4
OFFICE USE ONLY
gat
I4 LIST
LI OWNER - BUILDER FORM
(Attach)
LI FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
U CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $ �, 6
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
LI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
U IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
(sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$ (0.01/sq.ft.)
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
LI CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
LI CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL 0 0
ISSUINr, OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL (305) 795 -2207 FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
MIAMI SHORES VILLAGE, FLA. N° 2039
JOB Z6 eefle.-
ADDRESS
INSPECTION 1 ? /3C-6 (= Pii —
TIME READY rg. 1 C
REMARKS:
INSPECTOR
DATE
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
E
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IC? 13232
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
I /
BI.
Subdi-
vision
Value of
Project $
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 ip the statements or specifications and at he assumes r sponsibility for work
r
done by his agents, servants or employees. •✓
Signed: r' " ti I ! f ' "_ BY i , �.`4. -4_
INSPECTOR
In consideration of the issuance to me of this permit I agree to brm 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 „aeirempleyee.
1 i 7
BY
DATE
Contractor's
License No
d .s.)
Amt. of
Permit
AUTHORITY
Permit No e5/ Date_ — C
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 Mime Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or nr.".. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address .. M LOBFIR .
Registered Architect and/or Engineer
L ASSE TER PLUMBING cou, No.....13_0 6
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed—No 8 0
State work to be performed and purpose of building (By Floors)_
New Building . Remodeling_
Size Septic Tank Type of Tank
Feat of Drain Tile __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. _Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
es.
Before me, the undersigned authority, a notary public, duly auth
-------------------- —
My Commission Expires
MIAMI SHORES Vii.tAG'ii
PLUMBING INSPECTION DEPARTMEK:
APPLICATION FOR PLUM G
No 8 0 street it._ E.. 94 3.t..
Block
Addition_ X_
(Signed)
Repairs No. of Stories. .one.
Capacity Gals
-- StreeLLE125.St
Subdivision
streetN ----- E094 St..
The undersigned applicant for this building permit does hereby certify that he understands and accepts h obhgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida nanent 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 s •f the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, ork to be performed tin, this permit, are
licensed by Miami Shores Village.
ster 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.
Notary Public, State of Florida
Plumbing Insp tor.
er u
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
SH " E "
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
rues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
/
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•0
POOL
I
CONTR. LIOT
—Aa.---
--
CHECK
Permit No e5/ Date_ — C
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 Mime Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or nr.".. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address .. M LOBFIR .
Registered Architect and/or Engineer
L ASSE TER PLUMBING cou, No.....13_0 6
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed—No 8 0
State work to be performed and purpose of building (By Floors)_
New Building . Remodeling_
Size Septic Tank Type of Tank
Feat of Drain Tile __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. _Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
es.
Before me, the undersigned authority, a notary public, duly auth
-------------------- —
My Commission Expires
MIAMI SHORES Vii.tAG'ii
PLUMBING INSPECTION DEPARTMEK:
APPLICATION FOR PLUM G
No 8 0 street it._ E.. 94 3.t..
Block
Addition_ X_
(Signed)
Repairs No. of Stories. .one.
Capacity Gals
-- StreeLLE125.St
Subdivision
streetN ----- E094 St..
The undersigned applicant for this building permit does hereby certify that he understands and accepts h obhgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida nanent 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 s •f the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, ork to be performed tin, this permit, are
licensed by Miami Shores Village.
ster 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.
Notary Public, State of Florida
Plumbing Insp tor.
er u
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.
Date
Issued to
OWNER
aiami A o
F L O
PLUMBING PERMIT N9 813
LOT
BLOCK
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
building at
For a story
Fixtures
Fixtures $
Sewer $
Septic Tank $
SUBDIVISION
Total $
Village Plumbing Inspector
Received Payment by
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 4181
Work to be performed under this Permit
Architect
Contractor t -
or Builder
Legal Lot Bl.
Description
Subdi-
vision
DATE 194
Contractor's
License No
BY AUTHORITY
Address of c °i` r° . 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 with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. ,.. i .....0✓'"
s
,�
Signed: INSPECTOR By J
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 st • t conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting thii permit I ass me res sibility for all work done by eitherRryself, my agent, servant or employee.
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application fs 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 Street
Registered Architect and /or Engineer
Employing Plumber's Name No Street___
Location and Legal Description Lot Block Subdivision ^'
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank________ Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $
(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 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.
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA, t
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.
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
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
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application fs 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 Street
Registered Architect and /or Engineer
Employing Plumber's Name No Street___
Location and Legal Description Lot Block Subdivision ^'
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank________ Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $
(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 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.
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA, t
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.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No._ - 3 3 g
Date._.__ :__ � __.��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ .._. No. Street.
AA SEPTIC TANK CO. INC.
Registered Architect and /or
1123 E. 23rd ST., HIALEAIl
Employing Plumber's Name __ __ No.___. _ _ Street..
Location and Legal Description Lot 8.1 g fl 88-49 Blorti
Street and Number where work is to be performed —No
Amount of Permit $.
g
State work to be performed and purpose of building (By Floors) _ __._
New Building._. - - -_ _ ._ -_ _ -- Remodeling Addition.
Size Septic Tank_ - -.__ -- _- . - -•__- - Type of Tank
Feet of Drain Tile.0 Q fR! - __-Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well.____ ..... Size of Soakage Pit
Subdivision.._. . _.._
Street
t. /4 .._ 9 _y — -
Repairs No. of Stories
Capacity Gals.
( Signed )--- ._..-------- _..:._.._.._ .._...........e.:_ .__. = - .......
Pl ing 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 Worlanen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t sp.
COUNTY OF DADE.
(Signed).
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- 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 worlmvanship.
CLOSETS
BATH
TUBE
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUGS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No._ - 3 3 g
Date._.__ :__ � __.��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ .._. No. Street.
AA SEPTIC TANK CO. INC.
Registered Architect and /or
1123 E. 23rd ST., HIALEAIl
Employing Plumber's Name __ __ No.___. _ _ Street..
Location and Legal Description Lot 8.1 g fl 88-49 Blorti
Street and Number where work is to be performed —No
Amount of Permit $.
g
State work to be performed and purpose of building (By Floors) _ __._
New Building._. - - -_ _ ._ -_ _ -- Remodeling Addition.
Size Septic Tank_ - -.__ -- _- . - -•__- - Type of Tank
Feet of Drain Tile.0 Q fR! - __-Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well.____ ..... Size of Soakage Pit
Subdivision.._. . _.._
Street
t. /4 .._ 9 _y — -
Repairs No. of Stories
Capacity Gals.
( Signed )--- ._..-------- _..:._.._.._ .._...........e.:_ .__. = - .......
Pl ing 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 Worlanen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t sp.
COUNTY OF DADE.
(Signed).
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- 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 worlmvanship.
2676,
PeLaitt No......_..__._
Registered Architect and /or / 9:Timer_ ______ _�
Employing Plumber's Name!!1 '
Location and Legal Description Lot_ Block_ _
Street and Number where work is to be performed— No.._.__ •k 0 /
State work to be performed and purpose of building (By Floors)--------- .- .---- • -__ -.
New Building _._ Remodeling - -- _- ___ -- Addition..
Size Septic Tank
Feet of Drain Tile_.>z47 ...........
Nature of Water Suppl : City—Well.
Amount of Permit s--- .......
_ -_
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No d t! ` sv' Street.
Repairs
Date k
Application is hereby Trade 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 I .l!lA.6 t_
Type of Tank__
.-t_ -Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
- No.._ . r _. N ' W Street__ _
Subdivgen
Street 8 1.
No. of Stories.
Capacity Gals ....
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permane . upplement, and Ilas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo' 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 p is 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
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hiss 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.
CLOSETG
BATH
TUBS
SHOWERS
LAVA.
TORIES
INK6
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
_
CONTR.
LILT
--✓
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
P001.
CONTR.
LIST
CHECK
-
-_
2676,
PeLaitt No......_..__._
Registered Architect and /or / 9:Timer_ ______ _�
Employing Plumber's Name!!1 '
Location and Legal Description Lot_ Block_ _
Street and Number where work is to be performed— No.._.__ •k 0 /
State work to be performed and purpose of building (By Floors)--------- .- .---- • -__ -.
New Building _._ Remodeling - -- _- ___ -- Addition..
Size Septic Tank
Feet of Drain Tile_.>z47 ...........
Nature of Water Suppl : City—Well.
Amount of Permit s--- .......
_ -_
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No d t! ` sv' Street.
Repairs
Date k
Application is hereby Trade 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 I .l!lA.6 t_
Type of Tank__
.-t_ -Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
- No.._ . r _. N ' W Street__ _
Subdivgen
Street 8 1.
No. of Stories.
Capacity Gals ....
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permane . upplement, and Ilas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo' 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 p is 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
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hiss 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 other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mialni 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._.__ _7�J 1�
Registered Architect and /or Engineer
Employing Plumber's Name . -
Location and Legal Description Lot ��gg
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__
JO-
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block..__ -_
No.
(Signed)
Street
Subdivisio
Street_._..Y
Repairs__
(Signed) .
Date
' Street
2 -
P
No. of Stories
Type of Tank___ Capacity Gals
Dist. Feet of Tank or Drain Field from WeIL
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 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 arc
licensed by Miami Shores Village. -
aster 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 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 faul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N5
TOTAL
FIXTURE:
CONTR.
LIST
___
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
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 other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mialni 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._.__ _7�J 1�
Registered Architect and /or Engineer
Employing Plumber's Name . -
Location and Legal Description Lot ��gg
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__
JO-
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block..__ -_
No.
(Signed)
Street
Subdivisio
Street_._..Y
Repairs__
(Signed) .
Date
' Street
2 -
P
No. of Stories
Type of Tank___ Capacity Gals
Dist. Feet of Tank or Drain Field from WeIL
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 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 arc
licensed by Miami Shores Village. -
aster 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 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 faul
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
... 0 , DATE 194
PERMIT N? 7306
Work to be performed under this Permit
Owner of
Building
f ;
Architect
Contractor
or Builder
Legal Lot
Description
Address of > ' '" ti Value of Amt. of
Building 6 P roject Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or ddifice 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 co .n upon which this
permit is granted is the understanding that the contractor or builder named above assuxues the ros.6nsibility for a thorough knowled e o the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drains or,in e statements p( specifications a l -'1}e assumes respon-
sibility for work done by his agents, servants or employees.
» .Ladd
Bl.
E
Subdi-
vision
BY
''INSPECTOR
Contractor's
License No.
Signed.,*
In consideration of the issuance to me of this permit I agree to perfpi n 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 a work done by either myself, my agent, servant or employee.
y
.76;
AUTHORITY
a
1
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Address R 1JE Q
State
City �•_ �Q OU �h(Pc
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) I`CrLr Phone #
Zip
531 3�
Permit No. P12003" 3aS.
Master Permit No.
Mechanical Roofing
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 1 i) c q 4 .S+
City Miami Shores Village County Miami -Da Zip 33 1 3
Ls Building Historically Designated YES NO
Contractor's Company Name a ro uV t .l L t K' OJwkCC s Phone #
Contractor's Address min f p GO- "') T
.[n Pay ^
City as State E Zip 1 LP
r(ril()V I 020(62-
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Q -1 Obi 0
Square Footage Of Work:
Type of Work: DAddition DAlteration ew ❑ Repair/Replace ❑ Demolition ]]
Describe Work: V.A. y vt t i z. r <� 1 � -P c i y G-. c-t , or ca c ()-1- L4
.cE (K) e (50 gee,. gee1 .14 Y )i1 dor cyrvtuv1 . �' /7".€
CO3r'
* * * * * * * * * * * * * * * * * * * * * * * * *_* F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ 50 .00 Permit Fee $ / ( P O / � CCF $ 1 ` (�
( r
Notary $ Training/Education Fee $ f-, O Technology Fee $ (. S
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Company's Name (if applicable) *a,
Bonding Company's Address t'
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 LMPROVEMENTS 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. Als e tified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs s• n (7) ays after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and • ein • = Lion fee will be charged.
Owner or
The foregoing instrument was acknowledged before me this
day of 1 , 20 Q3by 11
who is personally known to me or who has produced NCO,
As identification and who did take an oath.
NOTAR ' P IC: "„" ,,, MViabel Vargas
_. _on #DD23198
Sign:
Print: Pnrl
t *c�79cn
My Con4j 6A e
+ t
•
• aa******* a*ss* xa******** s* s*** s****** * *a * * * * * * * * * * * * * * * : * * * * * *x * * * ** j,�, «.e 3C *x * * * * * * *s *aas * * *s
(Certificate of Competency Holder) ��� b. 1 t l li v i Ne
State Certificate or Registration No. / Certificate of Competency No.
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * ** * *.v.,"! *.r *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVE
Chc 10/14/03
Signatur
Contractor
The foregoing instrument was acknowledged before me this 4
day of bea, , 20 by
who is personally kn`miklutttgpvho has produced
A ' ,.:: who did take an oath.
NOTARY PURL r �N F� . ',
Sign: QN:
e •
Plans Examiner
Engineer
Zoning
Rene A. Eckert
Power of Attorney
1, Rene A. Eckert, authorize Rodney H. Rolph to act on my behalf and sign on my behalf
all documents and permits for any installations, improvements and property management
related to 80 NE 94 Street, Miami Shores, FL 33138.
SWORN TO and subscribed before me this S ay of kC b e/Y , 2003.
cfvfryvtrv),
Ndt'ary Public p�
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Around The Clock Gas Services
LPG017356 / CCN 02P000359
2216 West 80th Street, Say # 3
Hialeah, Fl. 33016
Phone: (305) 231-3632 / Fax: (305) 231 -4180
Installation done in accordance with FBC 2001, NFPA 54 & 58
regulations as well as all local codes
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Around The Clock Gas Services
LPG017356 / CCN 02P000359
2215 West 80th Street, Bay # 3
Hialeah, Fl. 33016
Oone: (305) 231 -35321 Fax: (305) 231 -4180
Installation done in accordance with FBC 2001, NFPA 54 8 58
regulations as well as all local codes
Job Address: O E, 9 '-f
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /5/2003
Applicant: RENE
Owner: ECKERT
JOB ADDRESS: 80
Contractor AROUND THE CLOCK
Local Phone: 305 - 556 -7667
Parcel # 1132060130300
Signed:
NE 94
(INSPECTOR)
Signed: (Contractor or Builder)
Plumbing Permit
Permit Number: PL2003 -325
ECKERT
RENE
ST
Contractor's Address: 16361 NW 57
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 1 & LOT 2 & E1/2 OF LOT 3 BLK 3 LOT
Fees:
FEE2003 -7998
FEE2003 -7999
FEE2003 -8000
FEE2003 -8001
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$180.00
$1.80
$0.60
$4.50
$186.90
Total Fees: $1 4H0
Total Receipts( $0.00 C
13 CC
Permit Status: APPROVED Permit Expiration: 6/1/2004 Construction Value:
Work: RUN LINE TO POOL HEATER AND BBQ OUTLET CONNECT NEW POOL HEATER UNDERGROUND 2 LINE AND 1/2 "BBQ
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.
BY:
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