262 NE 98 St (4)CONTRACTOR
New Construction
Name
-t rca\nrwA B e r r i e s ` C,
Address Z r ,Z M • E c S}
License No. C r c o 51 31 1 7
l� IJLJ eLC' `�
` 7 q (.Q - 6 0 C1 (p
Address
<60k l U.t 4 ; rat 3o 7ar waif •
K
r�1 i rc, i . r F L. 3 D 2
/
.
Telephone0 1 \ y 9 2 — g35 °159 )4/z/2 — 9 y 3
0
Qualifier Name l
1 1\\ 01/4 G ro\1n a v„..
Demolish
PROPERTY OWNS'
New Construction
Name \fir 40 r L eo In i
Address Z r ,Z M • E c S}
Home Telephone ( 05
` 7 q (.Q - 6 0 C1 (p
Business Telephone
.iArvl
/
.
Fax
Alteration Interior
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
V
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: 2 / 97
Address Apt. City State Zip
Folio Number Description of Work ?ILA rhb i r Q I n '4 1
Lot Block J
Subdivision PB PG Zoning
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work'(
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
J
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
6P
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No.
Linear Feet
Bldg Value
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
IMPORTANT NOTICES
AFFIDAVIT - Please read carefully.
PERMIT APPLICATION
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FR0M DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, BOUNTY OF MIAMI -DADE
Signatur- .f 0 'ser
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
Personally known OR, Produced Identification
STATE OF IIORID Y OF MIAMI - DADE
Signature ►' i n -tor / Q alifier
Print Na
•
Personally kni p,1
before me this ' 30 y 0 5, t
blic - State of Florida
JOYCE M. FOLSOM
M ' COMMISSION 4 CC 937748
EXPIRES: May 18, 2004
Bonded Thtu Ibltry p i ttemnit a r enti
ation ,
Type of Identification Produced: Type of Identification Produced: ADR1
Page 4
OFFICE USE ONLY
CHEC 'I LIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
( x .60) x/1000
$ (¢.005 / sq.ft.)
$ (¢.01 /sq.ft.)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 ° FAX (305) 756 -8972 m http : / /www.miamishoresvillage.com
ELECTRICAL
T) PE
Minimum Fee
Q.1.}'
.
Dryer
Q..}:
TYPE
Outlet, Appliance
(i'Y
.1-}.1,1,,
Service Repair
QTY
A/C Central 1 -3 Ton
A/C Central, Tons
Fan
Cooling Tower
Outlet, Wall
Heating Strips, each
Service, Temporary
Vent Hood, Cost
A/C Central 4 -7 Ton
A/C Wall/Win. Tons
Fire Pump
Dryer Vents, Number of
Outlet, Switch
Paint Booth
Signs
Ventilation, Cost
A/C Central 8 -15 Ton
Air Handler, Tons
Fixture - Fluorescent
Ductwork, Cost of
Oven
Piping, Flammable Liquid
Space Heater (kw)
Periodic Inspections
A/C Central 16-20 Ton
Barbecue
Fixture Light
Fire Sprinkler System
Parking Lot Lights
Process/Pressure Piping
Spas/Hot Tubs
A/C Central 20+ Ton
Bath Fan - Vented, #
Flood Lights
Fireplaces, Number of
Plugmold/Strip
Pressure Vessel
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
1
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
S.
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
'Ij
Service, Number of Amps
Water Heater New
l
MECHANICAL
TYPE Q'1'}'. a.1:ATE I Ty. TYPE QTY. "1'}'1'E FYI'}'.
Minimum Fee
"I'YI'E
Drains, Roof
Condensate Drain
'FVI'E
Miscellaneous Fixture
Generator
'r}'PI:
Soakage Pit
Refrigeration, Tons
Bath Tub
A/C Central, Tons
Drinking Fountain
Cooling Tower
Miscellaneous Repairs
Heating Strips, each
Solar Water Heater
Vent Hood, Cost
Bidet
A/C Wall/Win. Tons
Filter Replace
Dryer Vents, Number of
Pool Piping
Paint Booth
Sprinkler Repair
Ventilation, Cost
Cap - Fixture
Air Handler, Tons
Fountain
Ductwork, Cost of
Pump and Abandon
Piping, Flammable Liquid
Sprinkler System
Periodic Inspections
Cap - Water
Barbecue
Gas - Appliance
Fire Sprinkler System
Pump, Domestic
Process/Pressure Piping
Supply, AC Well
Cap - Sewer
Bath Fan - Vented, #
Gas - Natural
Fireplaces, Number of
Pump, Fire Stand
Pressure Vessel
Temporary Toilet
Catch Basin
PLUMBING
TYPE
A/C Condensate
QTY.
"I'YI'E
Drains, Roof
TV.
'FVI'E
Miscellaneous Fixture
QTY.
'r}'PI:
Soakage Pit
QTY.
Bath Tub
1
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
1
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
1
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
S.
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 41" Tile/Res.
Lavatory
'Ij
Septic Tank
Water Heater New
l
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
1
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Date
Type Insp'n
—a Permit No.
Na
Address
Company
Phone #
For Inspector: 1
Approve' °
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
rS D
Po
E
Miami Shores Village
10050 NE 2nd Avenue
Plumbing Permit
Phone: 305- 795 -2204 Permit Number: PL2002 -300
Printed: 11 /6/2002
Applicant: VICTOR LEONI
Owner: LEONI VICTOR
JOB ADDRESS: 262 NE 98 ST
Contractor GRAHAM SERVICES, INC. Contractor's Address: 8910 Miramar Parkway, Suite 307
Local Phone: 954 - 442 -9358
Parcel # 1132060134170
Permit Status:
Work: NEW FIXTURES FOR ADDITION
LEONI DEVELOPMENT, INC. 01 -92
225 NORTHEAST 34TH STREET, #203
MIAMI, FL 33137 -3800
PAY TO THE ,f/��!s f �e
ORDER OF f 191 *S■
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 5 & E1/2 OF 6 BLK 31 LOT SIZE
APPROVED Permit Expiration: 5/5/2003
UNION PLANTERS BANK
NATIONAL ASSOCIATION
3550 BISCAYNE BOULEVARD
MIAMI. FL 33137
63- 841/670
11'007698 1 :06 ?0084 Loo: II' L45000 L46 ?u
Construction Value: $1,000.00
// 7/1-
1 $ Y
Page 1 of 1
`Fp.o
Total Fees: $9:08
Total Receipts: $0.00
7698
DOLLARS 8 le
Ispection
herefor in strict compliance with all
ns that may have been submitted to
:he plans are changed without
ility for a thorough knowledge of the
assumes responsibility for work done
raining thereto and in strict conformity
sibility for all work done by either
11AaliJrlil Pii1110;
UMBit. /3 CONTRACT RS
RS
State Certified
CF CO57317
R�Ir. A.L. Graharvi
President
° Co mmercial
° industrial
Off: 954 - 442_9358
PO. Box 173636
Hialeah, FL 33017
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE,
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • 305-795-2204 '
Date S k* 6 3 Job Address 2 -4' 2 - , - 1S $►Tft:¢Aax Folio
Legal Description Historically Designated: Yes
Owner /Lessee/Tenet Master Permit #
Owner's Address Phone
Contracting Co. S t ' &V_ Address 21 ` N 1 L (p er Av
Qualifier ed sE NC, e • riac- d(Gd16/-- SS# Phone �S 7(c'73fo3
State # Municipal #
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 550.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION:
—I h G /at A•-x/ o / ._ri/t/ f4,/04/ syeA
Square Ft. Estimated Cost (value) / Oa Db
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 ANY 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 all disciplines.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating co .tr ion and zoning. Furthermore, 1 authorize the above named contractor to do • ork stated.
1
1
, or Owner Builder
Not
My Cornmission
ondo Presi . ent
Angola M Becher
.v My Commission D0150048
lixpircs Nicvomber 15, 200E
/� 6 (L' RADON
FEES: PERMIT
APPROVED:
Zoning Building
Mechanical Plumbing
C.C.F
Competency # Ins. Co.
Ir
Notary as 'tp o act
n
My • mmi ion xpi
Date
ht
Signature
rorOw
r s
NOTARY C _ C7 a
GO - 2_
'7CP -oc>
-, - fir.,,: : ,�,•
?iJ ; t ( '11 tr ,
•
•
BOND
psi /
TOTAL DUE 1
Electrical
Structural Engineer
c•I•v•I•t
E•N•G•I•N•E•E•R
Contreras Roofing
144 Northeast 26 Street
Miami, Florida
Project:
Dear Sirs;
LG ENGINEERING SERVICES, INC.
Consulting Engineers
2020 Northwest 7th Street
Miami, Florida 33125
Tel: (305) 649 -6454
Fax: (305) 541 -3298
TILE UPLIFT TEST
Residential Home
262 Northeast 98 Street
Miami Shores, Florida
Information provided by client:
Permit Number: BP 2002 -2100
Date Completion: May 19, 2003
Roofing Contractor: Contreras Roofing
LG Engineering Services, Inc. Project Number: LG03 -0782
(Testing Laboratory Certificate #00- 0224.07)
May 23, 2003
In accordance with your request and authorization, a representative ofLG Engineering Services, Inc.
completed the RoofTile Uplift Test for the rear addition at the above referenced project. This testing was
performed in general accordance with Roofing Application Standard RAS No.106 -- Standard procedure
for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid,
discontinuous roof systems.
The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof
is less than 30 feet above ground surface. The type of tile used for this project was reported to be Altusa
Roof Tile. This tile was reported to have been foamed in place.
At the time of this testing, one test for every corner, one test for every 100 square feet of roof tile in the
perimeter area and one test for every 200 square feet of roof tile in the field area were tested. Initially the
entire area of the roof was examine for loose tile. More than 10% of the roof tile located in the field area
and more than 20% of the roof tile at the roof perimeter and corner were physically examined.
Based on our test results, we conclude that the installation of the roof tile at the above referenced project
meets the test requirement outlined in the .above mentioned protocol Attached please find a copy of our
test report for your review:
LG Engineering Services, Inc. appreciates the opportunity of assisting you in this project. If you have
any questions or if we may be of further assistance, please do not hesitate to contact the undersigned.
Respectfully submitted;
LG Engineering Services, Inc.
ohamad Sonny Salleh, P.E.
Project Manager
TILE UPLIFT TEST
Residential Home
262 Northeast 98 Street
Miami Shores, Florida
Test Number
Test Load (lbf)
Test Status
1
35
Pass
2
35
Pass
3
35
Pass
4
35
Pass
5
35
Pass
6
35
Pass
7
35
Pass
8
35
Pass
9
35
Pass
10
35
Pass
11
35
Pass
12
35
Pass
13
35
Pass
14
35
Pass
15
35
Pass
16
35
Pass
17
35
Pass
18
35
Pass
19
35
Pass
20
35
Pass
21
35
Pass
22
35
Pass
Report of
TILE UPLIFT TEST
for
Residential Home
262 Northeast 98 Street
Miami Shores, Florida
Project Number: LG03 -0782
LG Engineering Services, Inc. -- Tile Uplift Test Result -- Project Number: LG03 -0782, Page 1
1
1
w
1
1
l
y
1
1
1
1
1
1
1
1
14 ID 12
19
16
11
19
2
18
D
9
10
20
22
9
8
1
4 9 6
26'
APITOXIMAt 1t5f ILOCA110N
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 If
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
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 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
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
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA '
RELAY
TELEVISION OUTLETS
DRAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
_AWN SPRINKLER SYSTEM
3AS RANGE
AFTER SET (GAS)
;AS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
O:TAINI:rD, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
LEGEND
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Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/8/2003
Applicant: VICTOR LEONI
Owner: LEONI VICTOR
JOB ADDRESS: 262 NE 98 ST
Plumbing Permit
Permit Number: PL2003 -124
Contractor's Address: 2801 NW 6 AVE
Page 1 of 1
Contractor JAFFER ASSOCIATES LTD
Local Phone: 305 - 576 - 7363
Parcel # 1132060134170 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 5 & E1/2 OF 6 BLK 31 LOT SIZE
T otal Fees: $0.00
Total Receipts: $0.00
MIAMI SHORES VILLAGE
TO THE
ORDER
OF.
Jaffer Associates Corp.
OPERATING ACCOUNT
2801 N.W. 6 Avenue • Miami, FL 33127 -3937
P.O. Box 370277 • Miami, FL 33137 -0277
Phone: 576 -7363 • Fax: 573 -8711
PAY *ONE HUNDRED TWENTY -FIVE AND XX / 100
MIAMISH
SunTrust Bank, N.A.
777 Brickell Avenue
Miami, Florida 33131
11 L0001, 211 0:066000604°: 100000E16 2?
DATE
06/09/2003
63 -60
660
100042
100042
CHECK AMOUNT
* * * * ** *125.00*
ER AS OCIATES CORP.
lining thereto and in strict
ne responisibility for all work
(1�
Permit No._ . , , - ,d
Owner's Name and Address ___
Registered Architect and /or Engineer
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Amount of Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date____ f 1
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.
No Street ........ -- ------ ________
- -- - --
Employing Plumber's Name .•— No Street-_3y- ttA
Location and Legal Description Lot---- :— _______ ________ — �__ ` __ ____Block Subdivision__—_____— ______ —___—
Street and Number where work is to be
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
_____ Type of Tank ___`_'. _¢t `✓' 3.__L ________________ Capacity Gals._____' -__-
Size Septic Tank
Feet of Drain Tile_______
Nature of Water Supply: City —Vt ' Size of Soakage Pit.
Dist. Feet of Tank or Drain Field from Well
(Signed) --------------------------------------
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. 4
(Signed) —
Mater Plumber.
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
No. of Stories__ - 04e,,.
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 /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
LIST
CHECK
,
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
(1�
Permit No._ . , , - ,d
Owner's Name and Address ___
Registered Architect and /or Engineer
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Amount of Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date____ f 1
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.
No Street ........ -- ------ ________
- -- - --
Employing Plumber's Name .•— No Street-_3y- ttA
Location and Legal Description Lot---- :— _______ ________ — �__ ` __ ____Block Subdivision__—_____— ______ —___—
Street and Number where work is to be
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
_____ Type of Tank ___`_'. _¢t `✓' 3.__L ________________ Capacity Gals._____' -__-
Size Septic Tank
Feet of Drain Tile_______
Nature of Water Supply: City —Vt ' Size of Soakage Pit.
Dist. Feet of Tank or Drain Field from Well
(Signed) --------------------------------------
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. 4
(Signed) —
Mater Plumber.
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
No. of Stories__ - 04e,,.
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 /or workmanship.
C
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal Lot BL
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE """ 194T
Contractor's
License No. '""' •°
PERMIT N° 2353
Work to be performed under this Permit
Owner of
Building
Address of y Value of Amt. of
-- -
Building
Project 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
application 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 responsibility for work done by his agents, servants or employees.
Signed. By (.
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 regula.
tions 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 responsibility for all work done by either myself, my agent, servant or employee._
Subdi-
vision
CONTRACTOR OR BUILDER BY AUTHORITY
JOB:
BUILDING
ELECTRICAL
PLUMBING
/
Inspector's Report:
•
•
•
•
•
The following is ready for Inspection:
i c y , j ig 1r
, d el •
AD:
• . DONE BY: ,l /�> -% n G �
. • : j.,
. REQUESTED :% :'%WILL BE READY
▪ •
•
•
•
•
•
JOB:
6
7,-" 3
BUILDING
ELECTRICAL
PLUMBING
•
•
•
•
•
•
Inspector's Report:
• •
• •
• •
• •
• •
• •
• •
/
9.
WORK
DONE BY:
REQUESTED
•
• • •
• •
•
• .
The following is ready for Inspection:
• •
AD:
•
:WILL BE READY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date .
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.
Permit
Owner's Name and Address _
Registered Architect and /or Engineer
Employing Plumber's Name _—_!
Location and Legal Descriptr Lot_ _Block
Size Septic Tank_____
Feet of Drain Tile_____ —,_
Amount of Permit $_w ____s__.
No Street___
No
Type of Tank
Nature of Water Supply: City— WAI _________ __________ _______ ___ ________ _____.Size of Soakage Pit
Subdivision _____________________—__.
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 Repairs No. of Stories___.,__x_ _..
_Capacity Gals.____
My Commission Expires Notary Public. State of Florida
Dist. Feet of Tank or Drain Field from Well_____ ____— _________ _______ __
--(Signed) --- ____________ __________________
_
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
/
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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.
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 /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
3�
CHECK
SEPTIC
TANK
SEWER
C
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
/
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date .
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.
Permit
Owner's Name and Address _
Registered Architect and /or Engineer
Employing Plumber's Name _—_!
Location and Legal Descriptr Lot_ _Block
Size Septic Tank_____
Feet of Drain Tile_____ —,_
Amount of Permit $_w ____s__.
No Street___
No
Type of Tank
Nature of Water Supply: City— WAI _________ __________ _______ ___ ________ _____.Size of Soakage Pit
Subdivision _____________________—__.
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 Repairs No. of Stories___.,__x_ _..
_Capacity Gals.____
My Commission Expires Notary Public. State of Florida
Dist. Feet of Tank or Drain Field from Well_____ ____— _________ _______ __
--(Signed) --- ____________ __________________
_
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
/
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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.
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 /or workmanship.