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1055 NE 96 StPermit No 7 60'o APPLICATION FOR ELECTRICAL 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 Registered Architect and /or Engineer Employing Electrician's Name.., /.. .o. . ' . :n�t, No Location and Legal Description Lot .. / 1.. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Ll Addition STATE OF FLORIDA, 1 COUNTY OF DADE. Il �-0 % . d (l41' o No._. /Arc ° Street 55. MIA'.' I SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) (.4)k Date Z 3 " r Street ' °C �a Street....p'-� .� Block 2 Subdivision.... 1..4... .a Repairs No. of Stories Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding ' Zt'> -2,... nt Permit $ -2-0 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ..ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. Master Electrician. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER . TOTAL CONTR. LIST qq // 1 R �/'/7� O /q/' i ,y 'a= C/ A7, I ©I S CHECK ENT. SW. DIST. CAB. SERVICE TCMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•5 HP NEON TRANS. RADIO TOTAL CONTR. LIsr ei CHECK / Permit No 7 60'o APPLICATION FOR ELECTRICAL 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 Registered Architect and /or Engineer Employing Electrician's Name.., /.. .o. . ' . :n�t, No Location and Legal Description Lot .. / 1.. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Ll Addition STATE OF FLORIDA, 1 COUNTY OF DADE. Il �-0 % . d (l41' o No._. /Arc ° Street 55. MIA'.' I SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) (.4)k Date Z 3 " r Street ' °C �a Street....p'-� .� Block 2 Subdivision.... 1..4... .a Repairs No. of Stories Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding ' Zt'> -2,... nt Permit $ -2-0 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ..ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. Master Electrician. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. r h Permit No / / New Building Remodeling STATE OF FLORIDA, l COUNTY OF DADE. T MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL 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 !d E, R. , L 4 z-- a HAM No / 055- Street AMr 4 Z 7 — • Registered Architect and /or Engineer !¢ ..... 11f.v R. Employing Electrician's Name... : .. e 4 -'p"2s C CC, 0 No ?- Street N • /C ' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No " 44.J Street State work to be performed and purpose of building (By Floors) /E/h 4 6/0t..a':r.6 • Overhead Underground v �� Service Size Feeders 1. .Conduit l t (!2 = Main Sw Addition Repairs No. of Stories Type of Installation— Conduit ...(.Tubing..� B.X.L Metal Moulding X/ 5 0 0 Atli 044 r Amount of Permit $ � (Signed) ..... .( 89. (Signed) 5 Date .5- -6 O I Q Amps 1 t.5 Main Fuses j 0 0 Amps Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hhiobligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' a 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. Master Electrician. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG REC FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. 3. 4 / sLk,'w s.a C i. Q a. N CHECK ENT. SW. DIST. SERVICE CAB. TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•8 HP NEON TRANS. RADIO TOTAL CONTR. LIST /' �o� • fa Leo Y I' A c. � o lvi ij r FAi • a o r 1. 00 1• e90 /f 66 Po p CHECK 1y 1 r h Permit No / / New Building Remodeling STATE OF FLORIDA, l COUNTY OF DADE. T MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL 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 !d E, R. , L 4 z-- a HAM No / 055- Street AMr 4 Z 7 — • Registered Architect and /or Engineer !¢ ..... 11f.v R. Employing Electrician's Name... : .. e 4 -'p"2s C CC, 0 No ?- Street N • /C ' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No " 44.J Street State work to be performed and purpose of building (By Floors) /E/h 4 6/0t..a':r.6 • Overhead Underground v �� Service Size Feeders 1. .Conduit l t (!2 = Main Sw Addition Repairs No. of Stories Type of Installation— Conduit ...(.Tubing..� B.X.L Metal Moulding X/ 5 0 0 Atli 044 r Amount of Permit $ � (Signed) ..... .( 89. (Signed) 5 Date .5- -6 O I Q Amps 1 t.5 Main Fuses j 0 0 Amps Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hhiobligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' a 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. Master Electrician. 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Contractor or Electrician NO. Outlets Motors Receptacles Generators Stoves aiami chores9llage *� F L O A ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , r. 19 STREET PART OF LOT LOT BL'K DESCRIPTION OF WORK Water Heaters NUMBER OF LOCATION Signs Billboards Other Apparatus SUBDIVISION N9 521 Permit Fee This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with e plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time on the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by s Department. , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with "application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami -s Village. Dated '' , 19 (Seal) — NO. STREET PART OF LOT LOT BL'K SUBDIVISION /®cd�-f , yy� ', f � Other A Apparatus 4 ., 9> 2 Outlets 2 Receptacles P Stoves Water Heaters Signs g Billboards Other A Apparatus Permit Fee 7° 2/ ✓, / 0 9 f ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Buildin Contractor or Electrician Dated aiami Aores91l1age F L O R ID A OFFICE OF ELECTRICAL DEPARTMENT zf Miami Shores Village, Fla., 19 LOCATION DESCRIPTION OF WORK NUMBER OF This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by this Department. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami Shores Village. N° 521 , Electrical Inspector. (Seal) MIAMI SHORES VILLAGE PERMIT No. Office of Electrical Inspector CERTIFICATE OF INSPECTION THIS CERTIFIES THAT the.wiring and apparatus installed at A ■ by `lf Address for ' t''. Range oWlf owner, and occupied as has been inspected and current is authorized to be turned on, until otherwise notified, for: Size of Service ' ' °` Number of Lighting Circuits watts. Water Heater watts Power: Connected load H P. Space Heaters ( 4e; watts Other Apparatus ELECTRICAL INSPECTOR. OUTLETS IiMOT0.EF RECEPTACLES GENERATORS- STOVES WATER H'TERB SIGNS BILLBOARDS OTHER APPARATUS MAIN G BRANCH Basement /' First FLOOR NUMBER OF SIZES OF INSULATION OPEN OR CONCEAL'D NUMBER OF CIRCUITS OUTLETS MOTOR GEN. MAIN SUB BRANCH Basement First Second Third Fourth Other Floors APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for issuance of permit for electrical installation as described below, and for inspection of same after installation: Owner Details of proposed work: Number of Motors Signature of Applicant H 11Wr- aiami Ohores i llage F L O R I D A Address e° Date 193. Building Contractor Electrical Contractor it Location of proposed work: Lot_, Block 2 Subdivision Building: Old or new Number of stories Used as Description of proposed work Volts Amps Phase Additional Information Address (if other than owner or contractor) (SPACE BELOW FOR INSPECTOR'S USE O Work begun Inspected �( /_ �/ Work finished Final inspection ,/' } ; �- t �. f2/ In OORB r 1A1 URCO 1..117LT NUMBER OF TOTAL OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIM SUBS BRANCHES ENT D H LOCATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION WILL BE RETURNED. LOT NUMBER BLOCK NUMBER STREET AND NUMBER OWNER 'r ✓. OCCUPANT OCCUPIED AS BUILDING - -NEW OR OLD (UNDERLINE WHICH) WORK -- ADDITIONAL, NEW, ALTERATION OR REPAIR SPECIFICATIONS H. P. OF EACH MOTOR VOLTS- TOTAL AMPS PHASF CEILING KIND OF INSTALLATION F BASEM FIRST SECON THIRD FOURT REMARKS )ROUGH WIRING BRACKETS DATE j 19 ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI Desiring your certificate of Approval, application is hereby made for an inspection of the electric installation in the premises stated below, for which undersigned agrees to correct any infractions of the National Electrical Code and the City Ordinance pointed out by In- spector. r RECEPTACLES SWITCHES FINAL No. • CORRECTED TEMPORARY DAYS. DATE ISSUED /APPLICATION MASTER ELECTRICIAN SUBDIVISION SIDE STOVES WATER HEATERS SIGNS SPACE BELOW FOR INSPECTOR'S USE ONLY NO OTHER APPARATUS OPEN OR CONCEALED KNOB. RX., BX.. MLDG.. CONDUIT, METALLIC TUBING >' G INSPECTION WANTED ` 6 BY �;_� a A DDRESS RECEIVED BY INSPECTOR INSPECTED PROGRESS WILL INSPECT AGAIN REMARKS FEE REMITTED INSPECTOR BUILDING ELECTRICAL PLUMBING Owner o Building Architect Contract or Builde Legal Descripti Address Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 3240 DATE Contractor's License No. Work to be performed under this Permit 194 This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed• By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY or r Lot pn Bl. Subdi- vision )f Value of Project I Amt. of 1 Permit BUILDING ELECTRICAL PLUMBING Owner o Building Architect Contract or Builde Legal Descripti Address Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 3240 DATE Contractor's License No. Work to be performed under this Permit 194 This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed• By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 19 Li PERMIT N9 6506 Contractors _— License No. 0 ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description II Bl Subdi- vision Address of .c� t C (J � S� Value of Amount of Building 7 I 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 applica- tion 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. Signed. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all'Ardinances an regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT.`* 1711 P7RFiIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 12 -12 -91 Job Address 1055 N.E. 96 St., Miami Shores Tax Folio 11- 3206 - 014 -3710 ; Legal Description Lot 12 & 13 Architect /Engineer Bonding Company Mortgagor N/A N/A N/ ROBERT. I S HAM Owner / Lessee / Tenant Owner's Address 1055 N.E. 96 ST. , MIAMI. SHORES Phone Contracting Co. COX INSURANCE REPAIR SERV. Address 390 WEST 22ND STREET, HIALEAH, FL. Qualifier CARL J. COOPER SS# 412 - 48 - 5820 Phone 887 -0315 State# CGC001891 W r Competency // 462 '�/j Master Permit it-?/-ei7 Address Address Address 758 -1528 Ins. Co. STATE FARM Permit Type (circle one). BUILDIN) ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost $4,000.00 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 and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. WATER DAMAGE REPAIR - SEE ATTACHED LETTER OF INTENT. Si nature of Owner and/or d /or Condo President Date: fa - 139/ Notary as to Owner and%or Condor Pre d My Commission Exp.ires PUBLIC STATE FL * * = COMMISSI,ON EXP JULY 19,1993 ■ MINDED THR4 GENERAL *NS. UND.* PERMIT FEE: APPROVED: Fire Zoning Buildin Mechanical Plumbing Signature of'Contract Date: J o) - 13 ( Notary as My Commiss * * to Contract 'r or Owner- Builder ion B6:TplB1r@dBLIC STATE OF FLORIDA *Y COMMIS*ON EXP JY 19,194 BONDED THRU GENERAL INS. UND. p� Other _/) Electrical Engineering * Date .: 4 Job Address IC),5 .4 Tax Folio //_ 74O_1Y / Y '" 32/0 7 Legal Description 35 31 / Lessee / Tenant y ��a�,, Master Permit # K/P, Owner's Address I 5 c( tz S' v Phone 7 55, - 1 Contracting Co .�nxv�� ;. r, a ..cav Address (oct 1v ,E CcsAiZ Qualifier -- 3A`c\r.., e' State 4 #1 mEgD_ L , Municipal ihnee5e&lPX3Competency 4 0 \3� 3 371tIns.Co. __ _____ _ __ Architect /Engineer llJN Address Bonding Company J A Address Mortgagor 14 1 f-\ Address Permit Type(circle one): BUILDING L PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION ®O �v Square Ft. Estimated Cost(value) 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 and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated Signature of o "er and /or ondo President Date: NI Notary as to Contract? r- Builder My Commission ExpireWtCDM $ ISSI 1BL ,N E STATE OF .21L g FI.OII 4 MY BODO . -THAit GENEAL III . (i b., 60r=0 THRU ., ** * r * * * * * ..4:.- * * * * * * * * ** FEES: PERMIT .. ` RADO C.C.F. . 5O NOTARY TOTAL DUE $ 34.50 otary as to wmer and /o My Commission `Expires.:,, PUBLIC STATE MY .COMMISSION EXP. A PERMIT APPLICATION FOR MIAMI SHORES VILLAGE President SS# - ` Phone 'JQ\- \`p \a gnature o ate: ctor or Owner- Builder APPROVED: Fire Other Zoning Building Electrical i t' r Mechanical Plumbing_ Engineering ---\' 3© .5 BY STATE OF FLORIDA COUNTY OF DMZ I HERESY CEF:T;FY t at this is t i copy of the original filed t is ofiic�"po� -� ay of �� , A D 1 WITNESS my h. nd and Official Seal. Clerk ' , i t Court PERMIT NO. COUNTY OF DADE DC, STATE OF FLORIDA TAX FOLIO NO. 11- 3206 -014 -3710 NOTICE OF COMMENCEMENT THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following Information Is provided In this Notice of Commencement. 1. Legal description of property and street address: 1055 N.E. 96 ST., MIAMI ,SHORES, FL. - LOT 12 & 13 2. Description of Improvement: WATER DAMAGE REPAIR 3. Owner(s) name and address: ROBERT ISHAM 1055 N.E. 96 ST, MIAMI SHORES, FL. Interest In property: OWNER - RESIDENCE Name and address of fee simple titleholder: N/A 4. Contractor's name and address:COX INSURANCE REPAIR SERVICE 390 WEST 22ND STREET, HIALEAH, FL. 33010 - 887 - 0315 5. Surety:(Payment bond required by owner from contractor, If any) Name and address: N/A 6. Lender's name and address: N/A Amount of bond $ 7. Persons within the State of Florida designated 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: N/A 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided In Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date Is 1 year from the date of recording unless a different date Is specified) This Document Was Prepared By Dale Cox Cox Insurance Repair Service 390 West 22nd Street Hialeah, Florida 33010 -,; zG L Signature of Owner Sworn to, ,and subscr lb before t h i s �3 day of ecemher, 19 i . Notary Pub I I c / My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA MY COMMISSION EXP JULY 19,1993 BONDED TNRU GENFRAI iuc lion HOME OFFICE 390 WEST 22nd STREET HIALEAH, FLORIDA 33010 -1486 December 12, 1991 City of Miami Shores Bldg. Department 10050 N.E. 2nd Avenue Miami Snores, F1. Re: Robert Isham 1055 N.E. 96 St. Miami Shores, F1. Dear Sir: We intend to do the following work at the above captioned address: 1. Remove & Replace Wallpaper Interior. 2. Interior Painting. 3. Pressure Clean Walks. 4. Miscellaneous Repair. Estimated Cost Respectfully, Carl ,I CC /iv SWORN TO apd subscrib 0 before me at Miami, Dade County, Florida on this I &D% day of ee e rrr ))er , 1 9( ) . My commission expires: NOTARY PUBLIC STATE OF FLORIDA BONDEDMTHRUOGENERAL JULY 19,1993 UND. UND. COX INSURANCE REPAIR SERVICE, INC. GENERAL CONTRACTORS - STATEWIDE LICENSED AND INSURED TAX ID. #59- 1218527 $4,000.00 NOTARY-PUBLIC DADE (305) 887 -0315 BROWARD (305) 522 -3966 DADE FAX (305) 887 -6038 BROWARD FAX (305) 522 -3973