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873 NE 96 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE r vate f > Job Address x'13 /VC qt Tax Folio Legal Description /IV & Historically Designated: Yes No !o�° Owner/Lessee / Tenant ( = / //O /M! Master Permit # ( �f 33 5) «3 7 ? ,2 Owner's Address ,? 3 W C. ?S S Phone 3 0 S - ?� Contracting Co. Am A.) /- 7 Ct?,/D/ 7? O 1U/A ) Qualifier .%/ / , At/ vsJ State # 4C14 2 3 C/ Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING(MECHANICM ROOFING PAVING FENCE SIGN WORK DESCRIPTION 0 ( @ t 5 - TvN Square Ft. Estimated Cost (value) /4110B- Y 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 don- ' compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contactor t• i o the wo d. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: XJ/ ' FEES: PERMIT RADON Address /1.. bt) 'Z 6 57. /4 7L61/', I . yo,/y< SS# Phone 30S - 8P - 5 6 22 V � Notary as toontractor or Owner - Builder My Comoltiloi ExpiresJOE ANON `,COMMISSION # CC625535 m EXPIRES MAR 02 200 BONDED ° (Pit v ATLANTIC BONDING CO.. INC. C.C.F. ' NOTARY BOND TOTAL DUE APPROVED: Zoning Building Electrical Mechanical ( ( f Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING /p KW DISHWASHER RECEPTACLES A/C (WIN)) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) S lrliC. / . DRINKING FOUNTAIN SERVICE SIZE IN ALPS DUCT WORK I11124 i' FLOOR GRAIN SERVICE REPAIR/6ETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUPO TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSLRE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK. POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE _ MOTORS OVER 5- 8 If TRANSPORTING ASSE1€LIES SINK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS / `AYta 4 A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS ` LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL CUTLETS COMMERCIAL WATER SERVICE ‘ SIGN TUBES ��// SEWER CONNECTIONS SIGN TRANSFORMERS f// � (01) UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES -, SEPTIC TANK ANTENNA 041 RELAY TELEVISION OUTLETS Oe 1 (:)0 GRAINFIELD, 4' TILE/RES. VIOLATION v 43 PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN Oi DISCHARGE WELL DOMESTIC WELL AREA GRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION • (AN 7?PLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT 3AS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APP I,ICATIONS.) ELECTRICAL MECHANICAL Owner's Name and Address_ • /�_dl 7/.z, - ti MIAMI SHORES VILLAGE Registered Architect and /or Engineer BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT �16 / 7 - �'f� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Name and address of licensed contractor if 2.5 e ,b ekG ie 6 Remarks (Signed) j f _. No.____ 7_ 5 Street G SY _ . 10/ dv 0, 4 Location and legal description of lot to be built on: Lot_ Block Subdivision Street and Number where work is to be done Q 73 /L) 16 -57 State work to be done and purpose of building (by floors) LZ9.. and for no other purpose. New Building Remodeling Addition Repairs No. of Stories .. ____ To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 75 _/6 5 . " Amount of Permit $ cl • 66 .Plan Cubage _Size of Building Lot Zone cubage required Distance to next nearest building — Maximum live load to be borne by each floor_ ____________________ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to_____ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations c an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for insp ction o the site the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcoItractor on wor to be p osmed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared — -- -- - -- -- -- -- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date _ („- Read, Sworn to and Subscribed before me. Disapproved Date_ ( Signed) Building Inspector ` My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. State work to New Building Remodeling To be constructed of Estimated Total cost of improvements $ ' s° C'`C%® be sent to.. STATE OF FLORIDA, COUNTY OF DADE. ss MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT done and purpose of building (by floors) ..... «...µ. '. v'. =: Remarks (Signed)_.._.,.« Notary Public, State of Florida c l p APPLICATION FOR BUILDING PERMIT '? " Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build . ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores %'illagc, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. �� Date... . .. _. »_.._ .. _....__ ..... ,18..! Owner's Name and Address . 'a F «....NO -. / .... Street_4 :.: Registered Architect and /or Engineer Name and address of licensed contractor.... 1s . ,.... . .:..: :s - 1 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done � a. .::., ..:, Permit No.__.-_ Date Read, Sworn to and Subscribed before me. Disapproved Date.._....__.._ (Signed) Building Inspector My Commission Expires r and for no other purpose. Addition Repairs No. of Stories Kind of foundation . Roof Covering Amount of Permit $. Zone cubage required plan Cubage Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans an specifications for said building. All notices with reference to the building and its construction may The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed, under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. to me well known, PLANNING BOARD DATE Chairman Member \fcrnber Member Member ...... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.