95 NE 96 St (4)1 MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 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
Owner's Name and Address ...._..Ad. -Qj ! '9 Q -� SIG No.
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work ton an purpose of uild'
Permit No Z Date
Disapproved
(Signed)
- ,r r f ,\ /Pate'
_
\
Building I,lspector
/r
?"`
Chairman
Member
Member ....- .
Council Approved Date
New Building Remodeling Addition Repairs No. of Stories
To be constructed of ind foundation ioof jering
Estimated Total cost of improvement d° / 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 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 as 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 inspection on th of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s,4 contractors, or to performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) --
Read, Sworn to and Subscribed before me.
Street
Att,P.
,19
and for no other purpose.
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 stgted are
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Member
Member
Member
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building I w
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE ^ 19
o PERMIT N9 4251 Contractor's
License No.
0
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
•
1 I.
Architect ` / `-
Contractor
or Builder — r i <.. , ( f
Legal Lot Subdi-
Description I B1 vision
Address of r � �
Value of Amount of
Building _ 1•- > Proiect_ Permit $
This permit is granted to the contractor or builder named med 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 ate 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.
\ s , INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compli a with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper uthorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
4/ ,.
Owner of 1
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
`I r
Architect
Contractor
or Builder
Legal Lot
Description II B1
N9 4218
DATE
Contractor's
License No.
Work to be performed under this Permit —_
19
Subdi-
vision
Address of Value of 11 Amount of
Building / ‘-' � ", . Project $ 11 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.
BY AUTHORITY ••1101 '!EROS
r
01/1;2/1998 09:10 ?01522372
l3 (�
�J �
Date Job Address
Legal Description
Owner's Address
Contracting Co.
Qualifier
Si:natur
Date:
APPROVED:
Lessee / Tenant
qs ♦v �: ! 6 # 7 & 4--
t k, W. Art _
Square Ft. Estimated Cost(value)
Notary as to Owner and /or Condo President
My Commission Expires:
0
** * * * * * * * *
FEES: PERMIT 1L RADON C.C.P.
Fire
ISM EL RAMi i_ (IEZ) PAGE 01
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
A 9X AV" Tax Folio /�r 341 013 -' O 4
� e44'
SSu Phone _ __ ___ _ ______
Address
State i PC O 0 Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BU LDING ELECTRICAL PLUMBIN - IIECHANICAL)ROOPING PAVING PENCE SIGN
WORK DESCRIP G A ` 7' I ! (7 4
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 APPIDAVIT: I certify that all the foregoing informat • is accur'te a d that all work will
be done in compliance with all applicable laws regulating con uction a ..n'ng. Furthermore, I
authorize the above - named contractor to do the work stated.
Notary as to Con
4147 Xiodkowleal( .0
My Commission spires:
* *
Master Permit !t
Phone
NOTARY TOTAL DUE
Other _
Zoning (� Building Electrical
- c /y
_Mechanical _ _ Pltunhincr Pnainaarine
.TEM
BATH TUB
UNIT
FEE
ITEM -
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
/0 kid
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
7)151-MASHER
RECEPTACLES
A/C (WIND)
2!SPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) -/
;,'KINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOCR GRAIN
SERVICE REPAIR/NETER CHANGE
REFRIGERATION
GREASE TRAP
i
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR -. -
f
RANGE TOP
UNDERGROUND TANKS -
_AVATORY
OVEN
ABOVE GROUND TANKS
LAUNCRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
":.OTHES WASHER MOTORS 0- 1
STEAM BOILERS
SHOWER j MOTORS OVER 1- 3 HP
HOT WATER BOILERS
_ �J
•:INK. POT /3 COMP. J j MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK. RESIOENCE F I 1 MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK. SLCP 1
MOTORS OVER 8- 10 HP
1
ELEVATORS /ESCALATORS
E.tiPCRARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
IRINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
1
' WATER CLOSET
•
MOTORS OVER 100 HP
_
VIOLATION
f
iNOIRECT WASTES
A/C WINDOW , .. ..
REINSPECTION
MATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT -
STRIP HEATER
1
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER-NEW INST. f
1 1 GENERATORS TRANSFORMERS
l
!
HEATER - REPLACE (
1 1 GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL 1
SPECIAL PURPOSE _
I
SWIMMING POOL I
I 1 OUTLETS COMMERCIAL
WATER SERVICE L
1 LSIGN TUBES
SEWER CONNECTIONS [
1 SIGN TRANSFORMERS
•
-
1
JTILITY -SEWER
[SIGN TIME CLOCK
-
TILITY -WATER
FIXTURES
=EPTIC TANK
ANTENNA
'FLAY
TELEVISION OUTLETS
1 AINFIELO, 4' TILE/RES.
_ VIOLATION
1J9 b ABANDON SEPTIC TANK
1 1 REINSPECTION
:3AKAGE PIT CU. FT.
_ _ _L
-
I
:ATCH BASIN
I I
!
:ISCHARGE WELL I
I I
I
NESTIC WELL I
I
I
:;EA DRAIN I
I �
100E INLET 1
I I
JAR WATER HEATER (
I I
IRE STANDPIPE
"J0L PIPING
.AWN SPRINKLER SYSTEM
;AS RANGE
¢TER SET (GAS)
;AS PIPING
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BE`:
OBIAKNED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
.ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
1
PERMIT NO.
;TATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSI6 ED hereby gives notice that improvements will be made to certain real property, and in accordance with
following Chapter 713, Florida Statutes, the Information to provided in this Notice of Commencement.
96 07iMt
1. Legal description of property and street address:
2. Description of improvement:
3. Owner(s),name and address: '\
. , . /17*/# o altos, 33/38- a70? 3
Interest in property:
Name and address . of fee simple titleholder:
4. Contractor's name and address:
5. Surery:(Payment bond required by owner from cant tractor, if any) •
Name and address:
Amount of bond
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon wpom notices or other documents may be served as provided .
by Section 713.14.(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself. Owner designates the following Person(s) to receive a copy o(the Uenor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration data of this Notice of Commencement: (the expir . Lion date is 1 year from the date of recording unless a
different date is specified)
sic 11 W f 01 • f '.f oh Banded mn,
Print Owners Name
Sworn to and subscribed before me this
Notary Public 41
Print Notary's Name 041/ (9 n
; OF Ft ORIDA, COUNTY OF DADE
C . 1 f a rr.L. is a PrvL c of tha v/y�
CARMEN L. POLLACK
C MMtS$trw # CC 477981
NOTICE OF COMMENCEMENT
TAX FOLIO NO.
II 30)06- 0/3— 0B go
G�i`C�Ga�a�i►caG
day of j2 /64h, 192L
aaW iPUn AMON RAuoowa9 `v a''a' '
666t9 hnr :S3lIIdX3 5 . ; '�`
1B6LLP 33 0 NOISSIWWO3
)tOKtlOd 'l N3V0f0
A f) 19 vi
eat.
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CENTRAL INSTALLATION OFFICE
Sears, Roebuck and Co. (5596)
3825 Forsyth Rd.
Winter Park, FL 32792
Prepared by:
�rll pi6tk.
Cam: ►NSTAI 1 ATION OFFIQt
Sears, Roebuck and Co. (5596)
3825 Forsyth Rd,
Winter Park, FL 32792
12=14: __: Y/di