386 NE 99 St (7)Contracting Co. r4 01. FeA, ,9"is/e'r • Address / 1 b I Al_
Legal Description Historically Designated: Yes No ■
Master Permit # i' f . p7- 3, 7 3,
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /— 3- 9 9 Job Address 3 I 9 / ,S27 e e7' Tax Folio //, 3) oL o) . 3 SS Q-
Owner/Lessee / Tenant At Sf/oi'c c a"- - (',4 r /•
4. A s�io � 3 i �P
Owner's Address /Y Phone
Qualifier
State # S' /a 0 9 • Municipal # .4E p 000Sss- - Competency # 311,5 15'r r - 3 Ins. Co. Uul 7 e) AV /off
Architect/Engineer ) h , Address
Bonding Company Address
Mortgagor ,,)' t Address
Permit Type (circle one): BUILDING ELECTRICAL P i MBING1ECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Or n q.
Square Ft. ,3 O o- o Estimated Cost (value) f i 'a oo, o c
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 regulating
construction and zoning. Furthermore, I apthorize the above -named contractor to do the work stated.
Signature ,j er and/or Conch President
Notary as to Or and/or Condo President
My C. , S� Expires:
_° ,llt IT # CC 733051
, 4c Expires May 19, 2002
� OF ATLANTII BONDING CO.. INC.
FEES: PERMITS v RADON
APPROVED:
Zoning Building
Mechanical Plumbing
/4/ 00
te
I 3 ( oo
Date
SS# Phone ,3 o _r - 9Po - 6)1'0•
ANNA QUINONES
MY COR•iMlSF.:i aN # CC 883682
E:+PIFF.. ikx 28.2003
141004.NOTMY RN. Notary tSwwoa r< Bonding G.
tractor or Owner- Builder
Notary as to Contractor or Own
My Commission Expires:
C.C.F. /' O D NOTARY — 0 BOND3I)D
TOTAL DUE
Electrical
3 o
Date
Structural Engineer
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
AISPLICATION FOR PLUMBING PERMIT
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th • Building Dig• lion
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.
Owner's Name and Address_ Miami Shores Comm. Church 386 N.E. 99thSt.
Registered Architect and /or Engineer _
Employing Plumber's Name _ -_ _.P BC SEPTIC TANK SERVICE - N o.. 3123 N. V. Street _ S th St
Location and Legal Description Lot _____ __ _ __ _ r ___ _ _ _ _ Block_ 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.--_
Size Septic Tank.-
Feet of Drain Tile. . - __
Nature of Water Supply. City —Well.
Ph.mbmrrg In,pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accrilts his oations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn ent Supplement, 'nd 1 as am-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work be perfo. ed under this per nit, as are
licensed by Miami Shores Village. ,/
(Signed)._ _ r_
Amount of Permit $ _
STATE OF FLORIDA, 1
COUNTY OF DADE.
c-
Type of Tank ____ _ .. ._ __ . . _
_ _Dist. Feet of Tank or Drain Field from Well._
_ Si r. of Soakage Pit
- - __ -- - - - - -- No.--- — —
____ Street_ _
Street
__ Capacity Gals.
Date February_ 20 1962 ... _ -_
No. of Stories _
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personall 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 apphcation, and that he did sign the same, and that all .acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
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
TUB6
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUSB
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
F0U ".T'N6
TOTAL
F XTUREU
CONTR.
LIST
CHECK
I
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WE..
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
AISPLICATION FOR PLUMBING PERMIT
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th • Building Dig• lion
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.
Owner's Name and Address_ Miami Shores Comm. Church 386 N.E. 99thSt.
Registered Architect and /or Engineer _
Employing Plumber's Name _ -_ _.P BC SEPTIC TANK SERVICE - N o.. 3123 N. V. Street _ S th St
Location and Legal Description Lot _____ __ _ __ _ r ___ _ _ _ _ Block_ 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.--_
Size Septic Tank.-
Feet of Drain Tile. . - __
Nature of Water Supply. City —Well.
Ph.mbmrrg In,pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accrilts his oations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn ent Supplement, 'nd 1 as am-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work be perfo. ed under this per nit, as are
licensed by Miami Shores Village. ,/
(Signed)._ _ r_
Amount of Permit $ _
STATE OF FLORIDA, 1
COUNTY OF DADE.
c-
Type of Tank ____ _ .. ._ __ . . _
_ _Dist. Feet of Tank or Drain Field from Well._
_ Si r. of Soakage Pit
- - __ -- - - - - -- No.--- — —
____ Street_ _
Street
__ Capacity Gals.
Date February_ 20 1962 ... _ -_
No. of Stories _
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personall 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 apphcation, and that he did sign the same, and that all .acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
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.