1163 NE 101 St (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 8/ Job Address 1/4 /1/(2: /4 31
Tax Folio // 52 05-- /9 dZZO Z
Legal Description /v1/// 6;7/ STZv 5 "
Lessee / Tenant Master Permit it 37-S DD
Owner's Address //(4' 3 Z /a/ S Phone
Contracting Co. - Z ELtC'T.Q /C)9% ()G/1/ -1- Address / 60x l '/
Qualifier /2A /E5id / " 1)4S# Phone 2 Z / - 3
�i2•
State it0o010Z/ Municipal # l Ya ` r 2 -' Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL 'LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION e-- c7€/ 0 - , /5 7, //71 7/0,/ , ' /¢e
Square Pt. Estimated Cost(value)
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
authoriz- the above -named contractor to do the work stated.qN
gna of owner and /or Condo President Signature
Dat _ ' ?, Date:
Notary as to,Owner •.o Condo President
My Commission Expires: ERNESTO FERNANDEZ
Notary Public, State of Florida
My Comm. expires Dec 16, 1997
NN. CC336910 *
PEES: PERMIT -;
** * *
APPROVED:
* *
Notar
My Co
NOTARY
RADON C.C.F.
Fire Other
Building
Mechanical Plumbing
Zoning
tatA >I3tio Src
£1:1 j• IsSION NUMBER
"?..% e
CC391278
• MY COMMISSION EXP.
OF FlO JULY 10 19
or or Owner- Builder
Builder
TOTAL DUE
Electrical 2 /)
Engineering
ITEM
BATH 1UB
UNIT
•
FEE
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 CRAIN
SERVICE REPAIR/1E1'ER CHANGE
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 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
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
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SIPPIY TO:
AIR CONDITIONERS -ew
l
•
A/C UNIT
,5-
STRIP HEATER /0g0
/
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL -
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
00MESTIC WELL
AREA DRAIN
ROOF IILET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
•
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT. APPLICATION
(AN APPLICATION FOR BUILDING PERMIT RUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
1'
i n/6
t C7 i;cid
PO NE L
601- 2/%7 e
( E Z Electrical Contractor, Inc.
40'1
or
Cr ROME
NiN e/ S7 ' g/S
1/6 Al 6 . 70/ Sr
m/;9n)1' S'/1Or6S -
Commercial • Industrial • Residential
P.O. Box 654407 • Miami, FL 33265 -4407
Phone: (305) 221 - 3109.0 Fax: 226 -3773
UCENSED & INS
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iJ/SCONECT
f0 136 REpLilCE
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Legal Description
Owner / Lessee / Tenant nag\CA c t v2,,V1 S Master Permit # 374" ��
3
Owner's Address 11 (p 3 N Pr ( S C e Phone 16(0 " 139 ri
Contracting Co. -p Vc�r knp, Inr . fl �1 . (T Address caet 151 ST()
Qualifier . ('I,Y\C t sc b ,CeZtiN0 SS # Phone 9
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle onee UILDING ELECTRICAL PLUMBIN( MECHANICAL OFING PAVING FENCE SIGN
WORK DESCRIPTION %avo&i.Q q f5 - tPrrv. ID t10 }vent. s.0 ` ._.�
Square Ft. Estimated Cost(value) 'i OOO.
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 const c ion -nd zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
of owner and
S
D
Notary a
My Commi
* *
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address I I (03 ■\ C ) D St Tax Folio //a.- 2/ }o as 6
Owner and /or,C
S 10fY ES'p OIAL NOTARY SEAL
2 (f l,�. - ROSA E WINSTON
.„ ;' * COMMISSION NUMBER
'° 1 1 P- , . , Q C4223
� '� Q MY COMMISSION EXP.
OF fV , OV. 21.1998
FEES: PERMIT 'I�,�'L MP"
Zonin
Mechanical
or Condo President
do President
Sign
D
Engineering_
Mn,
retractor or Owner- Builder
Notary a tractor o Owner-Builder
My Commi ='- icuit EtRiDetedIAL NO ARY SEAL
0, �) � ROSA E WINSTON
is * COMMISSION NUMBER
* * * *.o C42266 **
e MY OMMMSI N EXP.
4 F � NOV. 21 1998
C.C.F. NOTARY TOTAL DUE
Fire Other
Building Electrical
Plumbing
PERMIT NO. TAX FOLIO NO. 1/ 3a 06 /V0 0 .70
STATE OF FLORIDA: FL.
COUNTY OF DADE:
95R095280 1995 MAR 10 10:33
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with
Chapter 713. Florida Statutes. the following information is provided in this Notice of Commencement.
1. Legal scription of property and street address:
J
FL
2. Description of improvement:
tiA-ae JOk.
3. Owner(s) name and address:
//o3 ,f/.S. /o/
,
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
6. Lender's name and address:
Notary Public
Print Notary's Name
My Commission Expires:
. •v 1 • L. V1 `.vwtliy1L.1ev11.—sulr`1® 1
id/g
P y / en5
5. Surety:(Payment bond requ)rr d by owner from contractor. if any)
Name and address: ��
Amount of bond $
Print Owners Name
Sworn to and subscribed P ore me this 9 day of Hi+ 1. 19 . .
4,p,Rv PUd OFFICIAL NOTARY SEAL
FRANCISCO 0 CASTRO
`✓ COMMISS
AI err cc
71,019g
�e23,/' /V . '. /C/ s7 4/. e , F1. .2.1/e..2
By
7. Persons within the State of Florida desionated by Owner upon whom notices or other documents may be
by Section 713.13(1)(a)7.. Florida Statutes.
Name and address: /1/
C
8. In addition to himself.,Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
CC391278
at MY COMMISSION EXP.
OF F‘.y JULY 10 1998
STATE OF FLORIDA, COUNTY OF DADE
0 HEREBY CERTIFY That this is a fr e py of fho
on i n l fil ei in this office on a esr of
A 0 19
W MESS my h nd and Official Seal.
HAAVE RUVfl LERK,
Circuit and County Courts
Prepared by.
Address: 9 ' (//7 /9(
/44 gd,, j 2 s /4,Y-
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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.
Owner's Name and Address
Registered Architect and /or Engineer _
Name and address of licensed contractor__ ___ d •
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
f
State work to be done and purpose of building (by floors )_- 2( ^�
Disapproved Date
(Signed)
APPLICATION FOR BUILDING PERMIT
7
Date
No Street
Notary Public, State of Florida
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
,19 �j
:7
and for no other purpose.
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 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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such su ntracto s, on work to be performed under this
permit, as are licensed by Miami Shores Village. � ��__,w
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 Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved .pate 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.