MECHANICALDate
11/14/95
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address
803 N.B. 99th .ST
NO
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant Francis J. LuBien Master Permit #
Owner's Address 803,N.E. 99th ST,. Phone 753 4060
Contracting Co. MINER Address
Qualifier SS# Phone
State # 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 REPLACE 4 TON AIR HANDLER AND DUCT WORK
Square Ft Estimated Cost (value) $1,20.0
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 authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
dO
FEES: PERMIT fl' RADON
APPROVED:
Zoning
Mechani
Tax Folio
11 3206 034 0000
Signature of Contractor or Owner- Builder
Notary as to Contractor or Owner- Builder
My Commission Expires:
\NtY P ✓ Cr "i=lGi.iL NOTARY SEAL •
W DAMS
1, COM,MiSSis�N NUMBER
� ja CC255237
C. .IdY:MWIJN EXP.
11/14/95
Date
Date
C.C.F. 1.00 NOTARY 5.00 TOTAL DUE 54,00
Building Electrical
Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 9/22/94 Job Address 803 N.E. 99 ST. Tax Folio 11 3206 34 0090 9
Legal Description
Owner / Lessee / Tenant FRANK LUBIEN Master Permit # 3g g/
Owner's Address 803 N.E. 99 ST. Phone 758 4060
Contracting Co. OWNER Address
Qualifier SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING . ECHANIC ROOFING PAVING FENCE SIGN
WORK DESCRIPTION REPLACE INSULATION AROUND AIR CONDITIONING DUCTS
Square Ft. N/A Estimated Cost(value) $800.00
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
authorize the above -named contractor to do the work stated. , � j , t e n A
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
p, 0, OFFI IAL NOTARY SEAL
< / SANDRA M MONTIEL
* COMMISSION NUMBER
** * * * * * * * * * *
* UC4O12S1
9
Q�. MY COMMISSION .EXP.
FEES: PERMIT 36,60 RADON C.C.F. ' � NOT ° �' ' X11' AUG : _ i _7 . 1998
APPROVED:
Zonin
Mechanic
Fire Other
*
Signature of Gontrae4oaer Owner- Builder
Date'
- c /hGyr - 1 q -91
Notary as to Guinmeter..or Owner- Builder
My Comm
�.. I I' Jr
Building Electrical
lumbing
Engineering
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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 Villa 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.
Lot1..a.... Block .7o .9 Subdivision
, treet and Number where work is to be done " 4./.
`State w"otlrto be done and purpose of building (by floors)
or notices as are required by the Act. The undersigned agrees to employ only such
pennit, as are licensed by Miami Shores Village.
Remarks (Signed).
Permit No._ Date Zr Lt.— ? ��
Disapproved
(Signed)
GB
Chairman
Member
Member
My Commission
Member
Member
Member
yy /
Owners Name and Address ..l:J . iSl. ' !'' `R.l .l.. _ No.. Street.LY.4- _.°l. 1.. 5'7' —
Registered Architect and /or Engineer ..... 0.-+1. .
Name and address of licensed contrictor G..A/ / 2 70
...Location and legal description of lot to be built on:
F
g 9 5 -
and for no other purpose.
Addition Repairs No. of Stories
New Building Remodeling 4—
To be constructed of Kind of foundation p R Covering
Estimated Total cost of improvements $ . , / -� Amount of Permit $�. �? _
Zone cubage required plan Cubage
Distance to next nearest building ..........a.._/T Size of Building Lot
Maximum live Load to be borne by each floor
- 1 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 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 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 ublic notice
PLANN C BOARD DATE
ntractors, on work to be performed under this
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
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.
ead, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known,
Expires
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application nfter approval has been obtained from
the Planning Board.
A re-inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials and/or workmanship.