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655 NE 97 St (13)Permit No { Amount of Permit $__ ! STATE OF FLORIDA, } COUNTY OF DADE. walGQ 0 SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PPLOCCtaT!1I 4 1 FOR PLUMBING PERMIT Block (Signed)._ Date_ 3 Application is hereby made for the appri val of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This applicatic n 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 complis d 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 o. eels • Registered Architect and /or Eng'_eer «' i � Employing Plumber's Name �' ; ' ' L "� � -- �=-- - - - - - - -- - - - -._ No.---- - - - - -- Street- - Location and Legal Descripti . : ' • t Street and Number where work is to be3 >erformed —No A/2_4= 97 Street_ Stat • rk to be performed and purpose of building (By Floors) _ _— Remo deling Addition________ Repairs No. of Stories Size Septic Tank_ _________ ----- ----- --- ------ - - - - -- -- -___ Type of Tank Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water SuppCityj ell._____ __________________Size of Soakage Pit Capacity Gals My Commission Exl ices Notary Public, State of Florida umbing Inspector. The undersigned applicant for this b silding permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensat on 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 po ,t 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 igrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authorit :', 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, thl.t 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 $1.01 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty materials and/oz workmanship. CLOSETS TUBS TUBS SHOWERS TI TI iRIS RIE6 SINKS SLOP SINKS LAUNDRY TuBB U RINALS CATCH BASIN FLOOR DRAIN DRINKING FDUNT•NS ' TOTAL FIXTURES CONTR. LIST �- O . / 4 0 . - CHECK - -- SEPTIC TANK SEWER CONN. DRAIN FIELD SO'KAGE PIT GREASE TRAP i HEATER DEEP WELL SPRKLR. SYSTEM SW M POOL F� spo 0 V- J) w, ¢i COHTR. LIST 0` - p p CHECK Permit No { Amount of Permit $__ ! STATE OF FLORIDA, } COUNTY OF DADE. walGQ 0 SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PPLOCCtaT!1I 4 1 FOR PLUMBING PERMIT Block (Signed)._ Date_ 3 Application is hereby made for the appri val of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This applicatic n 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 complis d 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 o. eels • Registered Architect and /or Eng'_eer «' i � Employing Plumber's Name �' ; ' ' L "� � -- �=-- - - - - - - -- - - - -._ No.---- - - - - -- Street- - Location and Legal Descripti . : ' • t Street and Number where work is to be3 >erformed —No A/2_4= 97 Street_ Stat • rk to be performed and purpose of building (By Floors) _ _— Remo deling Addition________ Repairs No. of Stories Size Septic Tank_ _________ ----- ----- --- ------ - - - - -- -- -___ Type of Tank Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water SuppCityj ell._____ __________________Size of Soakage Pit Capacity Gals My Commission Exl ices Notary Public, State of Florida umbing Inspector. The undersigned applicant for this b silding permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensat on 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 po ,t 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 igrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authorit :', 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, thl.t 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 $1.01 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty materials and/oz 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 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. j , ,/ Owner's Name and Address Registered Architect and /or Eaginee ______- Employing Plumber's Name__e a—`' C'1-.-.) No._ Location and Legal Description Lot_ /' Street and Number where work is to be performed —No R i7 o State work to be performPd and purpose of building (By Floors) ____ New Building /! Size Septic Tank a - Feet of Drain Tile 4 Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ Block Remodeling_ Addition No.___ Street. ( Signed)___< (Signed)_ Date fr2 - Street_._ Subdivision Street. __� 6 Repairs No. of Stories. J -. ale " �� _((-- -_Type of Tank__ ` pacity Gals .._. - _ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply.' 'ell.----- -_-- �.-- ------- -__. -- _ -- -.Size of Soakage Pit bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as 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 w rk to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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 /ox work*ornship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS U URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT' NS TOTAL FIXTURES CoNTR• LIST CHQCK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW !MVO POOL CONTR. LIST _. CHQCa - 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 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. j , ,/ Owner's Name and Address Registered Architect and /or Eaginee ______- Employing Plumber's Name__e a—`' C'1-.-.) No._ Location and Legal Description Lot_ /' Street and Number where work is to be performed —No R i7 o State work to be performPd and purpose of building (By Floors) ____ New Building /! Size Septic Tank a - Feet of Drain Tile 4 Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ Block Remodeling_ Addition No.___ Street. ( Signed)___< (Signed)_ Date fr2 - Street_._ Subdivision Street. __� 6 Repairs No. of Stories. J -. ale " �� _((-- -_Type of Tank__ ` pacity Gals .._. - _ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply.' 'ell.----- -_-- �.-- ------- -__. -- _ -- -.Size of Soakage Pit bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as 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 w rk to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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 /ox work*ornship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo /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 regulatioan: of the Building Division of Miami Shores Village shall be complied with, whether pacified or not. A copy of approved plans and specifications must be kept at building during progress of work. Vff Owner's Name and Address . —._ I_. tegistered Architect and /or Engineer 3mploying Plumber's Name (P.t!-/ 211.. ldi;eg Location and Legal Description Lot. Illork /'' ` Street and Number where work is to be performed —No _y- . .1 r / Street. ' b � ..�, .. State work to be performed and purpose of building (By Floors)_ __.1�.�._ �__.._.1_.f. _ Permit No - ' " New Building Remodeling Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT iPPLIC>.TION FOR PLUMBING PERMIT (Si Before me, the undersigned authority, a notary public, duly authorized to Dote No ._. is Street ._! / . 2 7 S7 C . � . , . , : Street.. . 2- w t' Addition..._..._ Repairs L No. of Stories Size Septic Tanlc .---- - - - - -= ------- - - -• -- ..Type of Tank__ Feet of Drain Tile._. — _—_ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. __ — -- _---- _ - -___ .__ __ __ -- -Size of Soakage Pit Capacity Gals. (Signed)7T; — 41t 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 5988, Compiled General Laws of Florida Permanent Cum lement, and has con - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors nployed ly him in ti-e work c b' performed under this permit; and will post or cause to be posted' for inspection on the site of the wor pub]; notice or no'icer as tun- required by the Act. The undersigned agrees to employ only such sub - contractors on . k to :..air this p ennic, as SE • licensed by Miami Shores Village. Massa, Plumber. 'stet oaths and take acknowledgments, personal:;' cppeared Notary Public, State of Florida 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 be has carefully read the foregoing application, and that be did sign the same, and that all Eacts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made wheat such re-inspection is made.neoessary by improper notice for inspection, ur *putty materials and/or workmanship. CLOOQTO BATH TUBa S HOWQRO LAVA. TORIQO SINKS SLOP SINKS LAUNDRY TUSS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL FIKTI'RUB CONT. A LIOT -- CHECK SEPTIC TANK SQWQR CONN. DRAIN HELD SOAKAGI PIT GREASE TRAP SOLAR HEATER DIQP WILL SPRKLR. SYSTEM SW IM'G POOL CONTR. LI 07 CHECK —. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo /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 regulatioan: of the Building Division of Miami Shores Village shall be complied with, whether pacified or not. A copy of approved plans and specifications must be kept at building during progress of work. Vff Owner's Name and Address . —._ I_. tegistered Architect and /or Engineer 3mploying Plumber's Name (P.t!-/ 211.. ldi;eg Location and Legal Description Lot. Illork /'' ` Street and Number where work is to be performed —No _y- . .1 r / Street. ' b � ..�, .. State work to be performed and purpose of building (By Floors)_ __.1�.�._ �__.._.1_.f. _ Permit No - ' " New Building Remodeling Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT iPPLIC>.TION FOR PLUMBING PERMIT (Si Before me, the undersigned authority, a notary public, duly authorized to Dote No ._. is Street ._! / . 2 7 S7 C . � . , . , : Street.. . 2- w t' Addition..._..._ Repairs L No. of Stories Size Septic Tanlc .---- - - - - -= ------- - - -• -- ..Type of Tank__ Feet of Drain Tile._. — _—_ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. __ — -- _---- _ - -___ .__ __ __ -- -Size of Soakage Pit Capacity Gals. (Signed)7T; — 41t 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 5988, Compiled General Laws of Florida Permanent Cum lement, and has con - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors nployed ly him in ti-e work c b' performed under this permit; and will post or cause to be posted' for inspection on the site of the wor pub]; notice or no'icer as tun- required by the Act. The undersigned agrees to employ only such sub - contractors on . k to :..air this p ennic, as SE • licensed by Miami Shores Village. Massa, Plumber. 'stet oaths and take acknowledgments, personal:;' cppeared Notary Public, State of Florida 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 be has carefully read the foregoing application, and that be did sign the same, and that all Eacts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made wheat such re-inspection is made.neoessary by improper notice for inspection, ur *putty materials and/or workmanship. •M1 Date ' - Lo - F 9 Job Address (055 / 77 57 Tax Folio Legal Description Lo - r i8 Mid (4)esf /-2.0FLo f 9 Owner/Lessee / Tenant Qe,aJ, s 4' to r re464- //e / n/ dvt, n/ V' Master Permit # Owner's Address (o 5 5 N e_, 9 7 S Contracting Co. Oil it 4 cl e S W Y o c..-0 vvt Qualifier C _ ti A- (1-e S (A) y o Lo vv, State # IOC, 05 4 Municipal # Competency # Ins. Co. Architect/Engineer Y IL TA 310 P, G Address 650 G 60 leo 3e frc..5 Ci ie. G/ f. Bonding Company Address Mortgagor Permit Type (circle one): ("I MOLDING ELECTRICAL WORK DESCRIPTION Poe L - i - P .1-- tte APPROVED: Zoning Mechanical Square Ft. Estimated Cost (value 0 00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO`MAY RESULT IN YOUR PAYING TWICE FO I" IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER O! AN ATTORNEY ]BEFORE RECO t -ING 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 pennits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing infonnation 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 wor. •tated. w / ��1r � .. r: ;J- .�L. ,.__. (//t/Y1 ;2/1/ ? Signature of owner and/or Condo President Da Owner and/or ssion Expires: D ec' 1 (90 qi O P 50 FEES: PERMIT 0 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE FFICIAL NOTARY SEAL LINDA M YOCOM NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC634654 O% EXP. RADON Address Si N.tary as to Contract My Commission Exp C.C.F. d Z NOTARY Historically Designated: • Yes No Address 7/ O At 7 @ tcpe- ' Phone �O5- 759_ 77,5-o SS# Phone ' - 5 /- ECHANICAL ROOFING PAVING FENCE SIGN Contractorder, �'bt D to ��'"' � Date or • �I ;WTARYSEAL s: GLADYS J t1ILLAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MY CO ISSION EXP MAR.1,2002 . 5 BOND 3 &Cq TOTAL DUE L i el Electrical Structural EngineerY6q/) 9� �/4 BUILDING ❑ ELECTRICAL ❑ PLUMBING ROOFING � ❑ Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Owner of Building Work to be performed under this Permit B1 N9 5445 DATE Contractor's License No. 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 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. Amount of Permit $ Signed. r INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with - a11 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 ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY •csoT BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building MIAMI SHORES VILLAGE, FLORIDA DATE •. ./19 PERMIT N? 5413 Architect Contractor or Builder — 1 Legal Lot Description Contractor's License No. Work to be performed under this Permit Subdi- vision Address of Value of I Amount of ' Building Project $ I 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 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 ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY ABBOT UILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical '' lumlbin Mechanical Roofing Owner's Name (Fee Simple Titleholder) K L 'et 1 PVV ' 4J Phone # 7, 0 7 S9 7 7 3 Owner's Address 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 A SS av .q) T� City l4- s. State F( Tenant/Lessee Name Phone # 3 0 S 7 'S ? . 7 7 �r(� s City Miami Shores Village County Miami - Ifs Building ! istorically Designated YES Job Address (where the work is being done) Contractor's Company Name Fd►'1 i r e �Ie.►1��0 Contractor's Address " B 63 e � City kk14rw'. a Qualifier \ Q. C \\.0 a-Z Total Fee Now Due $ (Continued on opposite side) 4,00 Miami Shores Village Building Department (° g O Permit Fee $ e `30 S NO Architect/Engineer's Name (if applicable) $ Value of Work For this Permit 3O0 fJ 0 Type of Work: EAddition aeration New Describe Work: ;. ,i ' Jt- • t r 11,t C CUtA- Submittal Fee $ Notary $ Scanning $ Radon $ Code Enforcement $ Structural Plan Review. $ Training/Education Fee $ CCF $ Permit No. Master Permit No. Zip * **** * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** vi? place ❑ Demolition Technology Fee $ Bond $ Bonding Company's Name (if applicable) Bonding Company's Address A .4, City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $ 500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will he delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3 D day of , 20 , by , day of See , 20 of by hey4 EIbca- , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. APPLICATION APPROVED BY Chc 10/14/03 (Certificate of Competency Holder) NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: 14 My Commission Expires: My Commission Expires: ARY SEAL ISOTO ORIDA COMMISSION NO. DD093674 006 117/06 State Certificate or Registration No. C - ******************************* **/ ************************************************************* l A ! �Ii►' . (o Certificate of Competency No. / ,a' Plans Examiner Engineer Zoning Contractor EMPIRE PLUMBING COMPANY Local Phone: Parcel # 1132060171890 Plumbing Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -285 Printed: 10/6/2004 Applicant: DENNIS KLEINMAN Owner: KLEINMAN DENNIS JOB ADDRESS: 655 NE 97 ST Contractor's Address: 1853 WEST AVE Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOT 18 & W1/2 OF LOT 19 BLK 101 LOT SIZE Fees: Description Amount FEE2004 -9812 Building Fee $130.00 FEE2004 -9813 CCF $1.20 FEE2004 -9814 Training and Education Fee $0.40 FEE2004 -9815 Technology Fee $3.25 Total Fees: $134.85 Total Fees: $135w Total Receipts: $0.00 6 -6S Permit Status: APPROVED Permit Expiration: 3/30/2005 Construction Value: $2,000.00 Work: KIT REMODELING WASHING LAUNDRY REPIPE NOV 0 5? Page 1 of 1 oas Signed: (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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: