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1135 NE 99 St (14)Date (i �� '-9) Job Address /6 ✓' / �`. 99 Tax Folio // f 5 /9 o7 9ps Legal Description & / 7g" `' 1 ` 5 -6 Owner / Lessee / Tenant Owner's Address Contracting Co Qualifier l/ State 4 `Z at WORK DESCRIPTION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE - $ Square Ft. Estimated Cost(value) Master Permit 4k Phone 7 — ` Q Vo AddressAr -e /- 19J- 7 /Ib Municipal #6 - / ,2 Zd97Competency #//34 Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICA PLUMBIN ) MECHANICAL ROOFING PAVING PENCE SIGN 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 regulatin: nn truction and zos.ng. Furthermore, I authorize the above -named contractor to do the work Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: ** * Signatu e o Date :� 9, trac or or Owner- Builder f�21er i Exp. ApfIl 3Q 1' My Commission as to * * FEES: PERMIT 92‘02 RADON C.C.F. r Jt NOTARY 5 4 O TOTAL DUE ✓ J ` 9 APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbin � `��� 0 ineerin g 6 ** � I • w aa„. .,,CV/IIMage4 • *1*Jorla-vwfmArk _ . *fiororot* " . 672* SePtio T r of D tititee (4 W NOT A materials and/or Permit `aft= h 11047 stzucture Ji r deshibed. and aH provisions of the La of Mann Shores Wang during p Owner's, Name sad Begistered Maginot eF yg Plumboes and Leg* Street and Nnuaber where State work to be TATE OF FLORIDA, COUNTY or DADE, I Before mn the undersigned • to me well blown, b of the above d therebs by him • \ m om STATE 0 r ; ( R 5EA 770? 3's e A yA 13L. v o. 407 / 3 /3.<, /C, l 7 g /1/1 1 A nJ\ / S h o /z 1 ( 1 ) - 4 4 ; lA PHONE NORTH DADE 3575 PATTERSON PLUMBING CONTRACTORS / -7u i3 (1. -1- AV, / — SINN• y r��y /— L-/1 N 3— WArt - INCORPORATED PLUMBING • HEATING • REPAIRS P. O. BOX 545 OJUS, FLORIDA e /77 W-4 i'Lcv6 it • 4 7:4 Emptoyhts Looagoe awl Leog V Street attg Ntag, State •‘ ,),. - be tr),' ni! N • - Feet of Tg Nature of * cr,', to ree veg itkrArri, of the a thereat hy mat • 4y Co f z Permit No ........... ___ Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT . -y -- . ---- -- 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 et building during progress of work. ((}} z Owner's Name and Address L No._ 0 Street./ L O. t,+l 1 3 Registered Architect and /or Engineer - �� ` - • ' - � - � t: = %�"'� - Employing Plumber's Name -• - - -- G= Location and Legal Description Lot. _._ L 3 SubdivWon. ra. -4- • r Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) -.. New Building Remodeling —_ _ ____ Addition Size Septic Tank_ .— .- _----------- - - - - -- - 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 NO „- - ..........._..,,..._..,, ale. 6tteet..._,.., Capacity Cals. • Street Repairs No. of Stories.... Plumiing spector. 7 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent 7 pplement, 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. STATE OF FLORIDA, t is. 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 dep ores 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. Notary Public, State of Florida NOTE: A re- inspection fee of 11.00 will be made when snots miespeetion it m.de by improper notice for inspection, or faulty materials and /or workmanship. CLOLLTL BATH TUes "ow". TORIES SINKS SLOP SINKS LAUNDRY TUae URINALS CATCH SABIN FLOOR DRAIN DRINKING FOUNT 'N• TOTAL FIXTURES CONTR. LIST — CHICK SEPTIC TANK SIWIR CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR NEATER DEEP WILL SPRKLR. SYSTEM SW IN •G POOL Co. NTit �- LIST CHECK f z Permit No ........... ___ Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT . -y -- . ---- -- 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 et building during progress of work. ((}} z Owner's Name and Address L No._ 0 Street./ L O. t,+l 1 3 Registered Architect and /or Engineer - �� ` - • ' - � - � t: = %�"'� - Employing Plumber's Name -• - - -- G= Location and Legal Description Lot. _._ L 3 SubdivWon. ra. -4- • r Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) -.. New Building Remodeling —_ _ ____ Addition Size Septic Tank_ .— .- _----------- - - - - -- - 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 NO „- - ..........._..,,..._..,, ale. 6tteet..._,.., Capacity Cals. • Street Repairs No. of Stories.... Plumiing spector. 7 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent 7 pplement, 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. STATE OF FLORIDA, t is. 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 dep ores 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. Notary Public, State of Florida NOTE: A re- inspection fee of 11.00 will be made when snots miespeetion it m.de by improper notice for inspection, or faulty materials and /or workmanship.