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.