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.