1140 NE 100 St (4)Type Insp'n
Permit No.
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date f/--0,Z Time
Address
Company
Phone
For Inspector:
Approved
Correction
Re-Insp'n Fee
PL O2-
+ Ve/040,55
r . 1,
APPROVED:
Zoning
Mechanical
77
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 4 - /(0 0 Lob Address / / 1 /0 N /60 0 s / • Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant eilyR6/1).D Master Permit # B p z 0 O Z - 74 7
4 /aU �
Owner's Address s Phone 24- "' / 0
Contractin Co. L 11 E -- 1
Qualifier DA-0i) ,L 4-s 3.0.1
7/
State # Cr—C 0 02l V Municipal # Competency # Falb /3 I/ Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Address (4r A/ / v 7
Permit Type (circle one): BU
)1:/ ING ELECTRICAIS PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
/fie •A-tae-z(
Square Ft. Estimated Cost (value) < 72 / 3 do d�
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.
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 • • • . - work stat:o �.
Signature f`b owner and/or Condo President
Date Signature of Contractor or Owner- Builder
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder
My Commission Expires: My Commission Expires:
Date
FEES: PERMIT � �Cf RADON C.C.F. � =�
OTARY BOND
TOTAL DUE D ■ 0 0
Date
Building Electrical
Plumbing Structural Engineer
ITEM
BATA 1U1
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISITYIASHER
RECEPTACLES
A/C (WINO)
DISPOSAL
SERVICE 1Eh1'ORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AhI'S
DUCT WORK
FLOOR CRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRH'
APPLIANCE OUTLETS
PRCCESS NU PRESS PIPING
INTERCEPTCR
RANGE TCP
UIUERGROUIU TANKS
LAVATORY
IV
OVEN
ABOVE G7R(X1tN0 TNIKS
LAUNDRY TRAY
E
WATER HEATER
U.F. PRESSURE VESSELS .
CLOTHES WASHER
w TORS 0- 1 IP
STEAM BOILERS
SHOWER
1
MOTORS OVER 1- 3 IP
HOT WATER BOILERS
SINK, POT /3 COW.
MOTORS OVER 3- 5 IP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 81P
TRANSPORTING ASSEhULIES
_
SINK, SLOP
MORS OVER 8- 10 IP
ELEVATORS /ESCALATORS
TEWORMY WATER CLOSET
MOTORS OVER 10- 25 IP
FIRE SPRINKLER SYSTEMS
URINAL
MJTOfRS OVER 25-100 1P
COOLING TOWERS
WATER CLOSET
1
MJTORS OVER 100 IP
A/C WINDOW
VIOLATION
REINSPECTION
INDIRECT WASTES
WATER SUPPLY T0:
A/C
AIR CONINTIONERS
UIIIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
NEATER -NEW INST.
GENERATORS TRANSFORMERS
HEAIER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMAINNG POOL
OUTLETS COMERCIAL
--
WATER SERVICE
SIGN "(CUES
SEWER CONNECTIONS
SIGN TRANSFORMERS
i
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4" TILE/RES.
VIOLATION
FLIP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT. •
CATCH BASIN
L-
_ _
DISCHARGE WELL
DOMESTIC WELL
- -_
AREA. DRAIN
•
____
100F INLET
•
i0LAR WATER HEATER
"IRE STANDPIPE
-� -
+•- •
VOL PIPING
-
AWN SPRINKLER SYSTEM
AS RANGE
ETER SET (GAS)
AS PIPING
/■UDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEr
OBTAINED, THE OWNER'S NOTARJ:ZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
FOR
PAY
TO THE
ORD OF
Bank of Aitierica„
ACH C43100277. •
61 ty !I cf c uftti ; 4: Vir - 50:r cir c $71,,
LASSETER PLUMBING CO INC
865 N.E. 130 ST.
N MIAMI, FL 33161
DATE
1000867 Lou 1:0630000471: 00387 33974710
- .1119111. ',1....2.EIOACIIM.3.7.r
8671
$ //O
DOLLARS =Tr
63-4/630 FL
893
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/18/2002
Applicant: RAYMOND MATEO
Owner: MATEO RAYMOND
JOB ADDRESS: 1140 NE 100 ST
Contractor LASSETER PLUMBING CO INC
Local Phone:
Parcel # 1132050190430
Plumbing Permit
Permit Number: PL2002 -93
Contractor's Address: 865 NE 130 ST
Legal Description: 5 53 42 MIAMI SHORES SEC 8 REV PB 43-67 LOT 7
&1 r/vt_a_,
Total Fees: $0.00
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 10/15/2002 Construction Value: $2,300.00
Work: PARTIAL REPIPE & RE -ROUGH MASTER BATH
Page 1 of 1
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above 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 have 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 of the ordinances and regulations pertaining to the work
covered hereby whether on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees.
•
In consideration • e % 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, s ents 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:
(INSPECTOR) BY:
Signed: (Contractor or Builder) BY:
BLK 178 LOT SIZE
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
1
Lot
MIAMI SHORES VILLAGE, FLORIDA _
DATE r � 1194�L
PERMIT N° : • .413 5 License No or's
CONTRACTOR 011 BUILDER
Bl.
Work to be performed under this Perim
\ r, .��,.
Subdi-
vision
t .A
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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 have 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 of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the st ements or specifications and that he assumes respon-
t j sibility for work done by his agents, servants or employees. h✓ " O
Signed 4 By
INSPECT
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 responsibility for all work done by either myse agent, servant or employee.
Value of
Project
Amt. of
Permit
AUTHORITY