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1065 NE 96 St (6)LICIT CHECK \ SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G TANK CONN. FIELD PIT TRAP H EATER WELL SYSTEM POOL - CONTR. LIST CH1ICK Permit No - - - 1393 (_ — —_ Owner's Name and Address_ _________ an - - -, _ - Registered Architect and /or Engineer .. MIAMI SHORES VIL6 GE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date November 4 1971 Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. This application is made in comphance 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 th Building Di Sion 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. __ - . __ -- No._________ 1065 N.E. 96th street . Miam Shoheb Employing Plumber's Name .._ -2 46tied i bd„}3,,g Co • _i }i• . No. 10 8.3 E_t__ 2 3)14 _ _ street . H eah, -_F i. - -- . Location and Legal Description Lot_--_._.__- -- __._._ ..._ __ - -- _._ Block_ _ Subdivision. . _.. . Street and Number where work is to be performed —No. 1-0.6 5 N . E . Street Miami Shakes - State work to be performed and purpose of building (By Floors)_ - )Q.-.4 et. { LX,tWt b - -- - - - - -- -- ---- New Building ____ _ • _ -- ...... Remodeling____ -- .- _ - Addition__•- - - --- - - -- - . Repairs_ _. -. _ . _ __. No. of Stories . Size Septic Tank_._ _ _. __ -- - -. -- Type of Tank _ Feat of Drain Tile___ -. __ -_ __ _ _. _ __ _ _ -_ moist. Feet of Tank or Drain Field from Well.. Nature of Water Supply: City —Well. __.. __ __- _ _ _ _ -_ _ Si of Soakage Pit Amount of Permit $ - _ $ 4.0 0 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, rn+1 1 as om- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no Ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. (signed)__ _.- -- -- STATE OF FLORIDA, COUNTY OF DADE. - (S�ed) - -1 � �,_ l- _. .Capacity Gals. -- 0 .. . . _. - Ph.mb!:.g In.pecto. My Commission Expires Notary Public, State of Florida Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts 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 \, S SHOWERS L LAVA- S SINKS S SLOP L LAUNDRY U URINALS C CATCH F FLOOR D DRINKING T TOTAL CONTR. 1 1 -,0 e 1 1 -.b e Permit No - - - 1393 (_ — —_ Owner's Name and Address_ _________ an - - -, _ - Registered Architect and /or Engineer .. MIAMI SHORES VIL6 GE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date November 4 1971 Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. This application is made in comphance 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 th Building Di Sion 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. __ - . __ -- No._________ 1065 N.E. 96th street . Miam Shoheb Employing Plumber's Name .._ -2 46tied i bd„}3,,g Co • _i }i• . No. 10 8.3 E_t__ 2 3)14 _ _ street . H eah, -_F i. - -- . Location and Legal Description Lot_--_._.__- -- __._._ ..._ __ - -- _._ Block_ _ Subdivision. . _.. . Street and Number where work is to be performed —No. 1-0.6 5 N . E . Street Miami Shakes - State work to be performed and purpose of building (By Floors)_ - )Q.-.4 et. { LX,tWt b - -- - - - - -- -- ---- New Building ____ _ • _ -- ...... Remodeling____ -- .- _ - Addition__•- - - --- - - -- - . Repairs_ _. -. _ . _ __. No. of Stories . Size Septic Tank_._ _ _. __ -- - -. -- Type of Tank _ Feat of Drain Tile___ -. __ -_ __ _ _. _ __ _ _ -_ moist. Feet of Tank or Drain Field from Well.. Nature of Water Supply: City —Well. __.. __ __- _ _ _ _ -_ _ Si of Soakage Pit Amount of Permit $ - _ $ 4.0 0 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, rn+1 1 as om- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no Ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. (signed)__ _.- -- -- STATE OF FLORIDA, COUNTY OF DADE. - (S�ed) - -1 � �,_ l- _. .Capacity Gals. -- 0 .. . . _. - Ph.mb!:.g In.pecto. My Commission Expires Notary Public, State of Florida Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty materials and/or workmanship. Permit No Location and Legal Description Lot_ Li Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Nature of Water Supply: City —Well SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date_L 7" 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. ' 1, Owner's Name and Address______ A - , A. G "`, 1 '1, "' ,No Street__% Registered Architect and /or Engineer — C Employing Plumber's Name___ t Street P n Block______ - Subdivision f' / , Street /V e • 1 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 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. ( Signed ) STATE OF FLORIDA, t l , COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the :foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when Such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST , I - (i ` ; _ b L "ai p `.5. -- .`.,.ice,.. • -- CHECK p • -, SWIM'G POOL SEPTIC TANK SEWER CO NN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM CONTR. LIST 4 j/ -'fi CHECK Permit No Location and Legal Description Lot_ Li Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Nature of Water Supply: City —Well SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date_L 7" 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. ' 1, Owner's Name and Address______ A - , A. G "`, 1 '1, "' ,No Street__% Registered Architect and /or Engineer — C Employing Plumber's Name___ t Street P n Block______ - Subdivision f' / , Street /V e • 1 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 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. ( Signed ) STATE OF FLORIDA, t l , COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the :foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when Such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. NN_ BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor _ ��r or Builder ;f �/ e' Legal Lot Description MIAMI SHORES VILLAGE, FLORIDA RMIT N? 6391 Work to b, performed under this Permi Address of II Amt of ' / Value of Building , Address i ., ✓ ■ Proje Permit / This permit is granted to the contractor or builder 'ame. a lave 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 conditi n up n which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge the or and regulations pertaining to the work covered hereby whether shown on the plans or drawings or the 'state ents or specifications and at he ass ies respon- sibility for work done by his agents, servants or employees. ; ; � ' � Nom- � By n • Signed. ` 9 �✓ 2° INBEE OR In consideration of the issuance to me of this permit I agree to perfor the work covered hereunder in compliance with it ordinances znot regulations; pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miamihdres—Village.' In a ep s g this permit I assume gsponsibility for all work done by ei er myself, my agent, servant or employee. Subdi- vision CONTRA, OR OR BUILDER' BY DATE Contractor's License No. AUTHORITY 194 r Permit No Application is hereby Lade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein descri A. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of + : Laws of the State of Florida, all ordinances of M iami Shores Village and all rules and regulations of the Building Division of Miami Shores Vil' ,e shall be complied with, whether herein specified or not. 'A copy of approved plans and specifications must be kept at building during prog oss of work. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber'3 Name Location and Legal .Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Amount of Permit $ ss. MIAMI SHOIR VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No // �' Street 4 New Building Remodeling Addition Size Septic Tank Type of Tank � `• No IiitALE , , a --- Block Subdivision_ • � Street �� ;l Date f3UX )Call Capacity Gals ' Repairs No. of Stories 1)50. Dist. Feet of Tank or Drain Field from Well Feet of Drain Tile ' Nature of Water Supply: City —Well Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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. ( Signed) 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. ----- ---------------------------------------------------------------------- ------------- My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FI %TURES CONTR. LIST . CHECK • SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DE:EP WELL SPRKLR. SYSTEM SWIM'G POOL . CONTR. LIST CHECK r Permit No Application is hereby Lade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein descri A. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of + : Laws of the State of Florida, all ordinances of M iami Shores Village and all rules and regulations of the Building Division of Miami Shores Vil' ,e shall be complied with, whether herein specified or not. 'A copy of approved plans and specifications must be kept at building during prog oss of work. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber'3 Name Location and Legal .Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Amount of Permit $ ss. MIAMI SHOIR VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No // �' Street 4 New Building Remodeling Addition Size Septic Tank Type of Tank � `• No IiitALE , , a --- Block Subdivision_ • � Street �� ;l Date f3UX )Call Capacity Gals ' Repairs No. of Stories 1)50. Dist. Feet of Tank or Drain Field from Well Feet of Drain Tile ' Nature of Water Supply: City —Well Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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. ( Signed) 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. ----- ---------------------------------------------------------------------- ------------- 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. nn�� aa / Date 0 2' Job Address /0io‘ 96 Tax Folio //"' 32� ° 071 - v�d Legal Description 6077/1.0//z. Lor /0 R.& NIAS{ - rai storically Designated: Yes No I Master Permit # Owner/Lessee / Tenant Z612 0U V Owner's Address FO 6 Awe Q ut 1-{gc. , )12 8 • Contracting Co. 73/0 1 OL. Address 79 / 5 y 1v f 3.38e Qualifier PCT82 S . AO KIT& SS# Phone .3otc-6res State # P � % Municipal # Competency # Stfaa Ins. Co.E%' iui)/VJ I Architect/Engineer Address Bonding Company Mortgagor i Permit Type (circle one): BUILDING ELECTRIC PLUMBING,, \ ECHANICALL �ROOFING PAVING FENCE SIGN WORK DESCRIPTION /20 L � cc/ U : = / v D `- ''e'6 iA1 6-#0tS f2 - HOTE12 Square Ft. Estimated Cost (value) "l O7 R 0 D . D 0 C2 aXe°ellf2le- ` Sim Signature of owner and/or Condo President Date My Commission Expires: FEES: PERMIT / ,3( RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Address Phone d 2 26 2 el 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 r' ' contractor to .work stated. kip Notary as to Owner and/or Condo President Date �I6tary to Contral tor My Commission Expire TOTAL DUE Signature of Contr ctor or Owner- Builder Date c5.e _ : v (I) u �� t�o r Date -\ � CI aye ANGELA M EEC - ;$ N 0 r4w ..., . �g 'n coxir,snow PUM& 1 II C . 7850 97 C1 (0 NOTARY 5 .. Oa BOND APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering .�I TO THE ORDER OF Applicant: JOANNE Owner: ZERN JOB ADDRESS: 1065 NE 96 Contractor i X 11 c. Local Phone: Parcel # 1132060143700 Permit Status: Approved BA CT., NO. 6-A MIAMI, FL 7899 N.E. 3313 Ag( Stfofic5 a cc Plumbing Permit Permit Number: PL2002 -234 ZERN JOANNE ST Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & W1/2 LOT 10 BLK 82 LOT SIZE P 13 - 0 r o 7)1,,i--c2,)-1 S- o () 136/P) Total Fees: $O: O $0.00 Total Receipts: Permit Expiration: 3/3/2003 Construction Value: 00 4702 it ICI moss U FOP BANK FIRST UNION FLORIDA B B MIAMI. FL 0004 ?0 2n' l 411 �� 64 321:20g 0p0025862 � ��0670 Work: REMOVAL OF 275 GALLON UNDERGROUND FUEL STORAGE TA" "' (Contractor or Builder) DATE i I '6 " 0O U)RS BY: =1 lI Page 1 of 1 Re- inspection • �lication herefor in strict compliance with all ;ifications that may have been submitted to es or if the plans are changed without ponsibility for a thorough knowledge of the that he assumes responsibility for work done °= pertaining thereto and in strict conformity _ . assume responisibitity for all work done by either FRIJM :B ZERN Date 012 (.- Job Address _ /0C / CO Sr Legal Description LoT a d wZ Gsr AO 1 a, 82 Historically Designated: Yes No /NuAMI hlo(CL:S ScL`t: 3 Owner/Lessee / Tenant RANI' V r elAA � A ) / W F-.12/1-) Master Permit # Owners Address V 0 . &' /9 e f71 0 lk S ,n2W Phone COO 2 " 262-s Address 98,9 �' J E � ^' � , or/t09 i�(- Qualifier r 8 . � i � VC.r.�n ss# phone . l 0U.' -e&s c -a V !_ State # e(--v '/ z Municipal # Competency # Ve9Z Ins. Co. T Z Architect/Engineer .Address contractin co. B1/oCx Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN � ,tip WORK DESCRIPTION OF 2 Gic c)l) UN 16-0 gL7 FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE - 32O& -CJdi -30)e - T LL GAS R2 SFACE 4017E12 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. OWNERS 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 d• the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: RADON C.C.F. FAX NO. :3057511610 Aug. 27 2002 01:44PM P1 APPROVED: Zoning Building Mechanical Plumbing Tax Folio 11 , LL!! ate aturc of Contractor o ilder er- Builder r;•:;;;;: OFFICIAL SEAL DEBBIE L. SUMAN NOTARY PUBLIC - State of Artrona MARICOPA COUNTY ,1Oc My Comm. Expires May 5, 2006 4 , Notary as to Contracto My Commission Expir NOTARY BOND TOTAL DUE Date Electrical Engineering Lewis and Roca 8/27/02 5:04 PAGE 2/2 FROM :B ZERN FAX NO. :3057511610 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE �� Date 6i2 /� Job Address /069‘ / (2 Tar: Folio p-320&-c) -Woo - o Historically Designated: Yes No u Deer per„ loT 1- wiz car 10 j r'3e. 8z maw ,1pr � Ownc/Lessoe / Tenant - h IVA �- 'ten`*' Owners Address Contracting Co. BR,) Cy • r�� Qualifier 3 . VAGc State #T el '! 2.' Municipal # C�GI�ly �y� �OZ �c 2� o , sod /d 98 to i 1 /�l) Alas ?, !Phone 2 , � Address 9899 der MIA w,t ./( one p V � competency* VeoPe Ins. Co. iv'+ /u17) Arc Balding Company Mortgagor Permit Type (circle on): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ere- D F 2 -!v ' � UN��=i2S �PA-v ) 3Thfairac 171/01L UPS R' Salee f /Es47 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 constructicat in this jurisdiction. I understand that separate permits ere 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 rcgul� truction and zoning. Furthermore, l authorize the above -named contractor to do the work stated Signature of owner an. Condo President Date Signature of Contractor or Owner-Builder or Condo President OFFICIAL SEAL BREE M. GATES Notary Public - State of Arizona YAVAPAI COUNTY My Comm. Expires Dec. 17, 2003 APPROVED: Zoning Building Mechanical Plumbing ;Ffid Date FEES: PERMIT RADON C.C.F. www,lrlaw,com Master Permit M Address Address Address Date Notary as to Contractor or Owner - Builder Date My Commission Expires: NOTARY Aug. 27 2002 01:44PM P1 BOND TOTAL DUE. Electrical Engineering PEN S4 UL P / g:tteO sii ri tt s tb e A statoce i)k veR 7899 NE BAY 4047T NIANI, PC 331384234 #6A 09-0?-46 N* 6-01 A CLASS D P.132 6//-46 327 c-0 19 0:09- 00 0 4 (44t--41-;;; 07;C-I.2-- /I ERM OEPARTMENTa ENVIRONMENTAL RESOURCES MANAGEMENT CLOSURE TYPE (check appropriate box) Underground Storage Tank or Piping System: Aboveground Storage Tank or Piping System: SITE DESCRIPTION FACILITY NAME: FACILITY ADDRESS: STORAGE TANK SYSTEM REMOVAL AND ABANDONMENT APPLICATION *Excludes Hydrant Line Systems and Oil and Water Separator Systems [/.Removal ❑ Abandonment in Place ❑ Removal ❑ Abandonment in Place Number of Storage Tanks and cavations; Size and Centers oLSto�$e Tanks or Piping Systems: I Z7C'(A N° jr Cam(, 01(. 9-0411 J M Z v 1 '16 Mr Stbkts , FOR LARGER FACILITIES ONLY (>1 acre) must include any adjacent streets and on -site buildings SCALED SITE SKETCH (minimum of 8 'h" x 11 ", at least two copies attached) PROPERTY OWNER INFORMATION PROPERTY OWNER or RESPONSIBLE PERSON: TITLE and COMPANY NAME STREET ADDRESS: •o CITY: 'fa) 4 tA MIS STATE: ARVoikA ZIP CODE: POLLUTANT STORAGE SYSTEM SPECIALTY CONTRACTOR (required for UST a d and : ground pi � closures only) �� szv 3 1 3 1 7 ( 0 1 141E # : 73C:S LICENSEE: LICENSE# and EXPIRATION DATE: DOING BUSINESS AS: .2)tLie I4C. CONTRACTO NAME: SIGNATURE: CONSULTAN , REPRESENTATIVE gvtC0 TbNOki= 'D BE ADVISED THAT A SIGNED COPY OF THE STORAGE TANK SYSTEM REMOVAL AND ABANDONMENT GUIDELINES IS REQUIRED Processing PROCESSED BY• TW 2/29/00 FOR DERM USE ONLY NOTIFICATION: COMPLETE [ ] INCOMPLETE [ ] UT #/FILE# IW# HWR# PHONE# DATE: Field Inspection Approved [ ] Disapproved [ Insp. Name: Signature and Date: ERM DEPARTMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT TECHNICAL GUIDANCE Storage Tank Section Airports and Contracts Section STORAGE TANK SYSTEM REMOVAL AND ABANDONMENT GUIDELINES The following conditions and recommendations are hereby incorporated as part of the storage tank system removal and abandonment application (also known as storage tank system closure application). Additional approval(s) may be required from other DERM sections, the local fire department and other governmental agencies having jurisdiction over the facility or scope of work. Closures at Miami -Dade County Airports will be coordinated through the DERM Airports and Contracts Section (ACS). All other closures will be handled by the DERM Storage Tank Section (STS). 1. DERM STORAGE TANK SYSTEM REMOVAL AND ABANDONMENT APPLICATION The application is valid for six months from the application submittal date and required to be submitted prior to performing any work on site. However, scope of work must be implemented in accordance with any regulatory timeframes. 2. INSPECTIONS All inspections must be scheduled with the DERM Inspection Coordinators at (305) 372 -6700 (STS) or (305) 372 -6816 (ACS) two business days prior to commencing any closure activities. Closure activities shall include removal or abandonment for underground storage tanks (UST), aboveground storage tanks (AST) and all piping. The inspections shall be scheduled prior to: A. Underground tank or piping removals: 1. Completion of the tank or piping removal from ground. Be advised that groundwater must be made accessible for the inspector B. Aboveground tank or piping removals: (at each applicable stage of removal process to document the progress and any potential contamination) 1. Completion of tank removal 2. Completion of the secondary containment removal C. Tank or piping abandonment in place: 1. Inspection of the clean inert UST 2. Collection of any soil or groundwater samples (split sampling with a DERM Inspector is required) 3. Filling of the UST with 3000 psi concrete slurry or FDEP approved cellular concrete foam 3. QUALIFICATIONS AND REQUIREMENTS A. All work for UST closures, including all applicable safety requirements, must be performed by a Pollutant Storage System Contractor (PSSC) possessing a valid license from the Florida Department of Professional Regulation. This is strongly recommended for AST closures. UT/File • Storage Tank System Removal and Abandonment Guidelines October 26., P999 Page 2 of 3 B. All work for any closure must be performed in accordance with the applicable requirements of Chapter 24 of the Miami -Dade County Code, Chapter 62 -761 of the Florida Administrative Code (FAC), and the United States Occupational Safety and Health Administration (OSHA). The DERM recommends that American Petroleum Institute (API) Recommended Practice #1604, and National Fire Prevention Association (NFPA) Standard #30 be followed, if applicable. Also, all work shall meet any requirements imposed by the fire department or any other governmental agency having jurisdiction over the facility. 4. DISPOSAL A. Underground Piping 1. All piping must be capped, removed, or filled with concrete, and all applicable vent risers removed 2. All components for underground piping must be drained B. Tank System 1. Any UST and AST components removed should be properly cleaned, marked, and disposed of in accordance with API #1604 and NFPA #30, as applicable C. Contents (including liquid wastes, decontamination wastewater and sludges) 1. Must be properly recovered prior to commencing any closure activities and disposed of within sixty days by a licensed waste hauler as follows: a. For liquid waste materials by a DERM Permitted Liquid Waste Transporter b. For solid waste materials in accordance with an approved DERM Solid Waste Disposal Plan For more information, DERM Liquid Waste Transporter Program Manager and Solid Waste Program Manager, (305) 372 -6804 5. CONTAMINATION A. Discovery of any previously undocumented soil or groundwater contamination 1. Within one day, notify the DERM Storage Tank Section (STS) Inspection Coordinator at (305) 372- 6716 2. Submit a properly completed Florida Department of Environmental Protection Discharge Reporting Form #62- 761.900(1) to the DERM STS 3. Per Sections 376.305(1) and 376.3071(5)(c), F.S. and Rule 62- 761.820, FAC, the owner or operator must "immediately undertake to contain, remove, and abate the discharge ". B. Discovery of any previously documented soil or groundwater contamination: 1. For free- floating product in an excavation, the DERM recommends recovery and disposal as stated above in section 4.C.1.a. 2. For all excavated contaminated soil (as defined by Chapter 62 -770, FAC, effective date August 5, 1999), the DERM recommends disposal as stated above in section 4.C.1.b. if the removal will significantly impact the restoration requirement of the site 6. DEWATERING If the excavation water is contaminated and dewatering is to be performed, a pretreatment system must be proposed for groundwater restoration. Contact the DERM Pollution Remediation Section at (305) 372 -6700 for pretreatment information. Be advised that a Class V permit will be required in addition to a dewatering permit. Storage Tank System Removal and Abandonment Guidelines October 26, 1999 Page 3 of 3 7. CLOSURE REPORTS A. For UST and AST closure systems subject to the requirements of Chapter 62 -761, (FAC), pursuant to Chapter 62- 761.800 (4)(a) then, 1. A Tank Closure Assessment Report (TCAR) prepared in accordance with the current Florida Department of Environmental Protection's "Pollutant Storage Tank Closure Assessment Requirements" (April 1998 or newer) must be submitted to the DERM PRS within sixty days of the closure if no evidence of contamination is detected. 2. For UST closures, a FDEP Underground Storage Tank Installation and Removal Form for Certified Contractors #62- 761.900(5) must be completed and submitted directly to the FDEP, and a copy to this office, within thirty days of the UST removal. B. For UST systems not subject to the requirements of Chapter 62 -761, FAC (i.e., residential, on -site consumptive use heating oil, or hydraulic lift), or exempt from a Chapter 62 -761, FAC, TCAR pursuant to Chapter 62- 761.800(4)(b), the following must be submitted to the DERM PRS within sixty days of the UST system closure: receipts and manifests documenting the proper disposal of all liquid and/or solid wastes (including any applicable UST system components), any soil and groundwater sample results, and if no contamination was detected, a proposal for abandonment of any remaining monitoring wells. However, 1. For abandonment in place of USTs, samples must be analyzed for the appropriate analytical group (as defined by Chapter 62 -770, FAC, or other analytical group as appropriate by the type of product) a. Groundwater analyticals must be collected from monitoring well (s) (MW) as follows: 1. 1,100 gallons or less requires 1 MW 2. greater than 1,100 gallons requires 4 MWs b. Soil samples must be collected from soil borings (s) (SB) as follows: 1. 1,100 gallons or less requires 2 SBs 2. greater than 1,100 gallons requires 4 SBs One soil analytical in each source area required Be advised that temporary or permanent wells installed at a site shall not be removed or abandoned until site closure is granted. 1, FOR THE CONTRACTOR OR CONSULTANT REPRESENTATIVE TO COMPLETE: IPSO Ali .44 SIGNATURE T LW 10/26/99 P T0 6 - (PRIN have received the above referenced guider e and DATE: Mabel Vargas From: bomberousa @bellsouth.net Sent: Wednesday, March 15, 2006 11:34 AM To: Mabel Vargas Cc: bomberousa @bellsouth.net Subject: Permit closure Dear Sir/ Ma'am, My name is Nick Marian, I live at 1065 NE 96th Street in the Shores. Several years ago we replaced an old, rotting wooden exterior door in our house. No structural elements were involved (such as walls or frames, etc). only an new door, purchased at Home Depot and meeting Dade County specifications, was replaced. I was advised to pass this information on so that you could proceed with closing the permit ( #BP 03 1979). Thank you and feel free to contact ne at 305 - 751 -8872 at your convenience. Nick Marian PS Thanks for clarifying the e -mail address. 1 Tel: (305) 795.2204 Fav BUILDING @EC PERMIT APPLICATION � -- FBC 2001 �� Permit Type (circle): Building Electrical Plumbing Owner's Name (Fee Simple Titleholder) MI Owner's Address I � /4E l s- 11 City t� 4 1 N(�'ll g10 . Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name � - Phone # Contractor's Address I City State 4 a-- Zip Qualifier /s•� Architect/Engineer's Name (if applicable) Phone # ( $ Value of Work For this Permit \ 1 0 01) ❑Addition Type of Work: Describe Work: to 6/ kite IJ 'f '_ 1 0l Ji~ v / 1 '� Submittal Fee $ Sb9eull:ISO Permit Fee $ CCF $ Notary $ 5.00 Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) 1V11dII11 31101 V iiiage C r o4 Building Department lick- cbc5c oil) 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 t v i- P,"( .3 1 t41 Permit No. p) PO I q 7� 1 Master Permit No. \ 0 � t\° L� V�� al ,�M Phone # e 5G6 - 75 7 8 ['Alteration Zip Phone # N4/8- loco‹ N Q&I County Miami -Dade Zip NOV W * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** Mechanical Roofing Square Footage Of Work: /-- A ❑New gRepair/Replace ❑ Demolition ( 5) 0.)C- . -� d1c5T' n _9 �5 D '5• Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) C1�c 7 r`1 Wl 19" '(7j CO / L CAW (� Mortga a Lender's Address ?O? (* c Oct City ' / A'U-�5 State Zip M 752&(o- C 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 constriction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b _ • and a rei pection fee wih( be charged. _ or Agent The foregoing instrument was acknowledged before me this day of , 20 O 3 by I�.li e- LatC,S Gai t v lei VI who is personally known to me or who has produced McSDdr, 24 ( Zs" - 0 As ide�}tification and who did take an oath Si Ma bel NOTAR ' IC: vP = Co ar$aS mmi DD231984 gn ! ' es: Ju 13 1 t Print: JAI / Ja , - ,r r. n Atlant fiondin hru My Commission Exp State Certificate or Registration No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 10/14/03 Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: (Certificate of Competency Holder) My Conunission Expires: Certificate of Competency No. • Plans Examiner Engineer Zoning ii Miami Shores Village Building Department Permiit N 0: ••Job ame_ BIDING CRITIQUE SHEET (�`zq�o3 10050 N.E2nd Avenue Miami Shores, Florida 33138 �Z 3 O Tel: (305) 7952204 Fax: (305) 756.8972 Date .e Typelnsp'n Permit No. Name er�, Address ) O 1 ( 2 j' For Inspector: Approv Correction Re -Insp' n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time