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308 NE 99 St (7)• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date J al7 / (7Job Address &8 LE- qq .S7 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant ,L V / C< 4 s2 4 h Master Permit # (4(0 2 T7 J) 1 16:2 1 / 6 3 Owner's Address J 02 k e Q Q S Phone 0 r Q 32 b ss A Contracting Co. S fi IZ f � & 11 A (R• ldress 400 t( 1 /, `7 b Iv . Ji 14(7, I41 Qualifier ED ( 46_0 Vi SS# - Phone 50� q 6 1'1/-1 State # CSC dS 7 0 2 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION It>< V 002 / L (I 2 64711 1100 h •--L f 1'7n-76 Square Ft. Estimated Cost (value) / 3 00 I / 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 wo will be donejn compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the wor tated. Signature of owner and/or Condo President Date ignature o Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON / otary as to C My Conunissi ecry C.C.F. NOTARY . BOND APPROVED: TOTAL DUE —S9. actor or Owner- Builder S/ 2 1 ,/60 dilate ctor or Owner- Builder Date OFFICIAL NOTARY SEAL S ROARITAMONTI L /;7 (FL 6 42 N EXPIRES OF PLC — DEC. 17,2002 Electrical Structural Engineer ITEM BATH TUB UNIT ./ FEE Cp 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 OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY 'Z )- OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER 1 ( MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE 1 (p MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS 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 2 a MOTORS OVER 100 HP VIOLATION INOIRECT 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 SWIMAING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS TRANSFORMERS JTILITY -SEWER ., SIGN TIME CLOCK JTILITY -WATER FIXTLRES ;EPTIC TANK ANTENNA tELAY TELEVISION OUTLETS IRAINFIELD, 4' TILE/RES. VIOLATION 'UMP & ABANDON SEPTIC TANK REINSPECTION ;OAKAGE PIT CU. FT. :ATCH BASIN IISCHARGE WELL IOMESTIC WELL AREA DRAIN .00F INLET OLAR WATER HEATER IRE STANDPIPE OOL PIPING AWN SPRINKLER SYSTEM AS RANGE ETER SET (GAS) AS PIPING ,ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL OWNER'S NAME 4r. & Mrs. J.B. WEBS'TEH PRESENT ADDRESS 398 _N.E: 99th Street LICENSE NO. PHONE NO. z JOB LOCATION (ST. OR AVE.) 3u8 N,E. 99th Street LOT 9 P 10 BLOCK 41 SUBDIVISION Miami Shores Sec # 1 GENERAL CONTRACTOR Richard Le Doyen ADDRESS 3970 N.W. 174th Street PHONE NO. LICENSE NO. /99�' 1 995 BUILDING PERMIT NO. 6034 DATE 9 - 12 - 57 7 •0 PERMIT FEE $ 7.00 BUILDER'S BOND NO. 2184 DATE 9 -12 -57 ALTER ZONE REQUIR CU. FT. NONE PLAN CUBE CU. FT. 3. • °° EST. COST $ 3,000 DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: C• H. Markel DATE 9 -12 -57 NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION REPAIRS DESCR IPTION ALTERATIONS FOR A ONE STORY RES. ALTERATION DESCRIPTION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS ..4 CERTIFICATE OF OCCUPANCY NO. ....C.. 0. ISSUED /."4" BY ��^ - �.��. / TO s"� Y"S BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION DATE FEE TEMPORARY SERVICE $ $ BEAMS & LINTELS $ S SEWER $ FRAMING SOLAR HEATER $ $ GAS $ S $ $ INSPECTIONS FINAL BY RE- INSPECT BY RE- INSPECT BY ROUGHING CLEAN -UP ROUGHING GAS CONTRACTOR PHONE PERMIT NO. 1 DATE FEE $ NEW BLDG. I ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ $ SEPTIC TANK $ S SEWER $ $ SOLAR HEATER $ $ GAS $ S $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING ROUGHING GAS H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK SOLAR HEATER FIXTURES & FINAL FIXTURES CONTRACTOR es■ fC, /? I PHONE FEE $ q PERMIT NO. 4(03 DATE [--ZO - • NEW BLDG. 1 ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE BY BUILDING ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ ❑ Work to be Owner of Building M .iZ h1 _, Architect t! E1 #1 t f , t ' Ni Contractor ,.. or Builder i + t t -$ a t1 LE 7 r rt Legal Lot Description 1 $ Bl. 4 Address of ( 9 c Building ° AE MIAMI SHORES °RN A � PERMIT N4 6034 c Signed r BY Value of Project $ y performed under this Permit t�1 u T 4 K" Subdi- C d vision M: 1 ...� , S.31,3 ,? t S Sec Amount of Permit $ This permit is granted to the contractor or builder nameBove 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't ave 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 • ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the s t•s' rents or specifica 'ins T that ` +e assu es responsibility for work done by his agents, servants or employees. J �i a i INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereu -r in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitte• the proper authorities of Miami Shores Village, In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or ployee. CONTRACTOR OR BUILDS/ AUTHORITY t ►ti 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. ___ Se [ / S 7 Owner's Name and Address ._. /"!,l _ f'-_.HR,1.....447 a. / ���IZ:STCR ` No.___ 0 S Street. . ij..f S1: Registered Architect and /or Engineer .... l /. f/f/ ` S , , / /7,1 R1( L �/� J T Name and address of licensed contractor.. :�tt_1.LQ LC,20. ‹A/ 2 NW l 7 S` 4 l Location and legal description of lot to be built on: Lot 1 t 1 0 Block '+1 Subdivision fr '"t t Street and Number where work is to be done 340 2 y State work to be done and ur ose of building (by floors) L e .Q r, b4/ D _ s 1 P P g ( Y ) 4 5 - -- pct f'l,�4. syn SQL £ s z. F /99(J ?c , 7 - 100 3 c[ xt t`c and for no other purpose. New Building Remodeling,V Addition Repairs No. of Stories...6. ...C.r To be constructed of Kind of foundation Rc� ,Covering Estimated Total cost of improvements $._.. ,040. 0 Amount of Permit $ 2 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 pennit 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 the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontra tors, A n work to be erforned under this permit, as are licensed by Miami Shores Village. Y.---- / / , • Remarks ( Signed) L` ^ ' i2-' _7, 7 STATE OF FLORIDA, COUNTY OF DADE. 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 Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan 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.