1130 NE 100 St (15)DaS
Type Insp'n
Permit No.
Name
Address
Company
Phone #
MIAMI SHORES VII:.
BUILDING-`DEPART
305- 795 -2204
Building Inspection Reque
.Inspection Date
Approved
Correction
Re- Insp'n Fee
6Ts- C3?
s�z J 01
10050 NI. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305
Date •
- - Address ( 30 NE /0047
Legal Description —AL..1 .
_. -
Lessee/Tenet UOIn n "F OR. I • T Y o uJ S k ∎
Owner's Address t 1 O N C t O 037
Contracting Co. a1 R A t r Co-.J. Co_
Qualifier O f �7 • Clue(/,
State# GAcoa6yit -1 Municipal# 048$02 -3
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): t} BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
,,
WORK DESCRIPTION: .;Q /1 64_ z I�.fJCM JNA
Square Ft. Estimated Cost (value) J 9 6.
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 construction and zoning. Furthermore, I authorize the above named contractor to do the work stated.
C ( 2 / P
Signature of owner and/or Condo President
Roy
Notary as to 0 r and/gj ondo President Date
My Commission Expi ife Robert 3. Chryst
:.: �!� 1.,1 MY COMMISSION# DD113321 EXPIRES
'"° May 24, 2006
BONDED THRU TROY FAIN INSURANCE INC.
PERMIT APPLICATION FOR MIAMI SHORES VILLAG
FEES: PERMIT / v o RADON C.C.F
APPROVED:
50.00 polo et S8'ly
Mechanical / '� Plumbing
Historically Designated: Yes No X
SS#
Date Signature of
Tax Folio
(""\J
Master Permit # )1C 2.00 `'t - 59
Phone 305%. 7£ I l a a S
Address P o •too)( l0 0 l 3 C /11;qrn l F/ 3 ( 8
Phone 3 0 6 M 3 14
Competency # Ins. Co. ITn - C3 r Cf
\•
Not as to Contractor
My Commission E.•.. "'
i.:
Zoning Building Electrical
ner Builder
ECEIRCED
APR 2 s 2004
756 -8972
or Owner !der
"iq ( . f Janet Kranz
MY COMMISSION # DD174033 EXPIRES
December 26, 2006
BONDED THRU TROY FAIN INSURANCE, INC
Date
Date
NOTARY BOND
a, S - (Po
TOTAL DUE
Structural Engineer
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE .
BIDET
LIGHT OUTLETS
CENTRAL HEATING i-_-_-10r
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) 1 IN
S9a�vh
DRINKIIIG FOUNTAIN
SERVICE SIZE IN A1+PS
OUCT WORK
FLOOR DRAIN
SERVICE REPAIR/1€TER CHikNGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
—__--
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 HP
HOT WATER BOILERS
SINK, POT /3 COAP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
MOTORS OVER 8- 10 HP
TRANSPORTING ASSE6BLIES
ELEVATORS/ESCALATORS
SINK, SLOP
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
JINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
SATER CLOSET- - .
INDIRECT
MOTORS OVER 100 FP
VIOLATION
WASTES
A/C WINDOW
REINSPECTION
CATER SUPPLY TO: ;^,
•AIR CONDITIONERS
•
A/C UNIT - '
-
. --
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
•
GENERATORS TRANSFORMERS
�—
HEATER - REPLACE '::-
GENERATORS TRANSFORMERS
LAWN SPRJWLER -WELL•
SPECIAL PURPOSE
—'
SWIMMING POOL
WATER SERVICE
EWER CONNECTIONS
TILITY- SEWER
TILITY -WATER
:PTIC TANK
OUTLETS COWERC I AL
SIGN TUBES
SIGN TRANSFORMERS
SIGN TIME CLCCK
FIXTLRES
:LAY •
IAINFIELD, 4' TILE/RES.
AP E ABANDON SEPTIC TANK •:
ANTENNA
TELEVISION OUTLETS
�--L
— +
VIOLATION ''—
REINSPECTION
IAKAGE PIT CU. FT.
_ .
ETCH BASIN
'SCHARGE
WELL
;MESTIC
WELL
;EA
DRAIN
OF
INLET
LAR
WATER HEATER
RE
STANDPIPE
OL
PIPING
nN
SPRINKLER SYSTEM
S RANGE
TER SET
(GAS)
3 PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
,..
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A RASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
•
PLUMBING
ELECTRICAL
MECHANICAL
hone: 305 -i :i -.204
Printed: 5/3/2004
Applicant: DALE OSTROWSKI
Owner: OSTROWSKI DALE
JOB ADDRESS: 1130 NE 100 ST
Contractor C & R AIR CONDITIONING CO Contractor's Address: 2121 NW 139 ST #10
Local Phone: 305 - 685 -6394
Parcel # 1132050190440
Fees: Description Amount
FEE2004 -4477 Building Fee $100.00
FEE2004 -4478 CCF $2.40
FEE2004 -4479 Technology Fee $2.50
FEE2004 -4480 Training and Education Fee $0.80
Total Fees: $105.70
Total Fees: $10.70
Total Receipts:' 0
SS/1 0
Permit Status: APPROVED Permit Expiration: 10/25/2004 Construction Value: $3,996.00
Work: EXACT REPLACEMENT OF 3 TON SPLIT SYSTEM
Signed: (INSPECTOR)
.' e Y In1z i' Lilit ei
Page 1 of 1
Legal Description: MIAMI SHORES SEC 8 REV PB 43 -67 LOT 8 BLK 178 LOT SIZE 75.000 X
MAY 0 6 PAID
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations 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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Zone cubage required_—
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 ,19
Owner's Name and Address 1 t' Je f' N-- P Street. -.1V � l
Registered Architect and /or Engineer ;
Name and address of licensed contractor.. ,,ERi3k_ 7?7. _QL• LNG• l4/ 4 4) v 1k f h • 17 4 " LyY..t!! P
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done ^r4 _ - ______
State work to be done and purpose of building (by floors)___ .7A , 53 7Y 4I IF,ISC.r!e.4.- !t
liT.1N_lr-
______ and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ � , �_ _O__L t 12 v __________ of Permit $
-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 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, Pennanent 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 subcontractors, on work to 1)e performed ender this
permit, as are licensed by Miami Shores Village.
Remarks--- --- - - - - --- -- -
(Signed)
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.— __L_ T_? 3 Date
Disapproved Date_
( Signed)
2a " 7 D Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Burl. g Inspector A Commission Expires
PLA " NC 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Disapproved
(Signed)
Build Inspector
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 T, 's ,196t
Owner's Name and Address • --" W k eV CO X- e-Al No 1 ‘ t, Street i E t t 09 •
Registered Architect and /or Engineer ........_ . tf�
Name and address of licensed contractor Al- (J Q • 19 -P ° D� 6V` l aria 6
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done j � D
State work to be done and purpose of building (by floors) ..___ - �p ` 0, p elf Ye, L RI- p
' Tc. •�
and for no other purpose.
New Building Remodeling..__ Addition Repairs No. of Stories
To be constructed of
Estimated Total cost of improvements $_ .1_.__ nv• Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building.... .. .... . ' Size of Building Lot
Maximum live load to be borne by each fl r__ 1
I hereby submit all the plans and spej'ficati ns for said building. All notices with reference to the building and its construction may
be sent to 10 Su N l E.
ind. df foundation
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 pos . 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 su h subcontrac ors, o to erfo ed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) • 1.4''
STATE OF . FLORIDA,
COUNTY OF DADE. J 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 ar
Permit No 2 ( S( r Date
Council Approved
Date
Read, Sworn to and Subscribed before me.
Roof Covering
Notary Public, State of Florida
My Commission Expires
PLA G BOARD DATE
Chairman Member
Member Member
Member Member
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..