121 NE 100 StApproved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
BUILDING
PERMIT APPLICATION
ED(' 2001
Permit 'Type (circle): Building {" Electrical �'�RRN Mechanical Roofing
Owner's Name (Fee Simple Titlleholder) S 1O(,(1�� ' T\lO(1 i Ine et -R 6Phone # a6 - — 150 - 7 3 Lj 5
Owner's Address 1I 2_1 � 1 3E. 1100
City \A LQ Y - O(t j State FL Zip 331 3%
Tenant /Lessee Name Phone #
.lob Address (where the work is being done)
City Miami Shores Villa / County Miami -Dade • Zip - 31 3 O
Is Building historically Designated YES _ NO
Contractor's Company Name A d a He I Q P-I
Contractor's Address I r'
City 1 " i. I k State 1 L-
Qnalilier t\-Ap �b SI�S
State Certificate or Registration No.
ilrchilect/Engineer's Name (if applicable) Phone it
$ Value of Work For this Permit
'type of Work: ❑Addition , Alteration
Describe Work: IQwn �r{�) klP,►2
Submittal Fee $ Permit Fee $ ( L
CCF $ CO /CC
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
'total Fee Now Due $
(Continued on opposite side)
1 Z 1 N..A 111 IJ ♦ 1 A 1�.4
Building Department
10050 N.E.2►►d Avenue, Miami Shores, Florida 331.38
Tel: (305) 795.2204 Fax: (305) 756.8972
N I A
0 COO �--
121 N t lop
ONew
Master Permit No.
Q+iC Phone # - �n - Lo 3 ZZ
Zip
Certificate of Competency No.
Square Footage Of Work:
Permit No. 6
9(0/ al
❑ Repair /Replace -; ❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City Slate Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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 constn►ction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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
COMMEN CEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) clays after the building permit is issued. In the absence of such posted notice, the
inspection will not be apt o► ed and a reinspection fee will be charged.
NOTARY PUB
Sign:
Print:
Chc 05/13/03
/
Signature �'�' A • Signature
Owner "Agent / rf ' ontractor
The foregoing instrument
u nent was acknowledged before me this 1 The foregoing instrument was acknowledged before we this /0
day of fee2UA -ily 20 OS, by , day of F S UwR—y , 20 by �1/( }R {� _
►o is personally known t� me or who has produced
As identification and who did take an oath.
Comma 000 238491 .
Exams 8/9/2007 ;
* * * * * ** * * * * * * * * * * * * * ** • p��unu � " - * . /02 PN u:(
as .
My Commission Expires:
*.I..� * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
►o is personally now me or who has produced
as identification and who did lake an oath.
NOTARY PUBLIC:
Sign:
Print:
My Col
Jorge Toledo
fission Expires:
� .? i° *•.F - Cor missi0Il # DD348926
• �� . :Q Ezpires: AUG. 22, 2008
* * * *Bcalk -44bn
,, Atlantic Bondi.ng Co., Inc.
****************44********************************************
Plans Examiner
Engineer
Zoning
S1)1
, 1 C ;-- 4/ I
k
Yr
e P
4/4 _i4dLS • 't
/2 it/ t /00 5... 7
frr, 4 , 5 *, 4,4 £
CC# 96P000219
Affordable Irrigation, Inc.
r 139 Street
Mia i, FL 33168
ni
/ 7 ,
7 / 46 /-
(3 2 ‘
306/
1• 47-)4 • --
EU
I P
Miami Shores Village
10050 NE 2nd Avenue
Printed: 3/3/2005
Applicant:
Owner:
JOB ADDRESS: 121 NE 100 ST
Parcel # 1132060132040
Plumbing Permit
Phone: 305- 795 -2204 Permit Number: PL2005 -62
Contractor AFFORDABLE IRRIGATION INC Contractor's Address: 198 NW 139 ST
Local Phone: 305 - 681 -6322
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 17 & E1 OFT LOT 16 BLK 15 LOT SIZE
Fees: Description Amount
FEE2005 -2791 Building Fee $160.00
FEE2005 -2792 CCF $1.20
FEE2005 -2793 Training and Education Fee $0.40
FEE2005 -2794 Technology Fee $4.00
FEE2005 -2795 Scanning Fee $3.00
Total Fees: $168.60
Total Fees: $168.60
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 8/21/2005 Construction Value: $2,000.00
Work: LAWN SPRINKLER
Signed: (INSPECTOR)
Page 1 of 1
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Permit No. Ir /
Application is hereby made, for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address fro 6 /34 S 514-- W /r/ 5 /- No / N /0
1.. 2 r 0 street .__._....._..- -•_ -.
Registered Architect and /or Engineer A C tL'
Employing Plumber's Name AL MF G/F 5 _ C °4 P .. No., / f / i .3 Slt6et — " o .
Location and Legal Description Lot
Street and Number where work is to be performed -No .__./ ' / M Street
State work to be performed and purpose of building (By Floors) -I y S 1-141/A14 e7 - / L d C y[ f ,$ 4" G /i $ L o
New Building _ Remodeling_ __ ____.__ Addition Repairs No. of Stories
Size Septic Tank_.— •------- - - - - -- - - - -- - _.Type of Tank -_
Feet of Drain Tile._____ ____ _ ___Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City-Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block Subdivision.- ..._.____.__._ __.
Capacity Gals ...
.__..__._._.Size of Soakage Pit
(Signed)_
-------------- -- - - -- -- - —
Plumbing Inspector.
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 5968, Compiled General Laws of Florida Pernane t Supplement, and has com-
plied 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 sub - contractors,, on to k to be performed under this permit, as are
licensed by Miami Shores Village.
(Siiined)
Master Plumber.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re-inspection is made'neoewry by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SH OWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
UR INAL{
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIN'O
POOL
CONTR.
r*,2
LIST
' L
fT 7/
CHECK
Permit No. Ir /
Application is hereby made, for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address fro 6 /34 S 514-- W /r/ 5 /- No / N /0
1.. 2 r 0 street .__._....._..- -•_ -.
Registered Architect and /or Engineer A C tL'
Employing Plumber's Name AL MF G/F 5 _ C °4 P .. No., / f / i .3 Slt6et — " o .
Location and Legal Description Lot
Street and Number where work is to be performed -No .__./ ' / M Street
State work to be performed and purpose of building (By Floors) -I y S 1-141/A14 e7 - / L d C y[ f ,$ 4" G /i $ L o
New Building _ Remodeling_ __ ____.__ Addition Repairs No. of Stories
Size Septic Tank_.— •------- - - - - -- - - - -- - _.Type of Tank -_
Feet of Drain Tile._____ ____ _ ___Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City-Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block Subdivision.- ..._.____.__._ __.
Capacity Gals ...
.__..__._._.Size of Soakage Pit
(Signed)_
-------------- -- - - -- -- - —
Plumbing Inspector.
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 5968, Compiled General Laws of Florida Pernane t Supplement, and has com-
plied 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 sub - contractors,, on to k to be performed under this permit, as are
licensed by Miami Shores Village.
(Siiined)
Master Plumber.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re-inspection is made'neoewry by improper notice for inspection, or faulty
materials and /or workmanship.
Date 2 -/7 AO Job Address / 2 / NE / (
Legal Description n /802/ " JOI - e5 See / / 9 / -7o Le /7 O /,' /S
Owner / Lessee / Tenant
Owner's Address /2/
Contracting Co. 00z5/Os Drr >` �
Qualifier U)u9 /a5 D`r
State # 2/952 Municipal # Competency # .00/2 3 Ins.Co. C "" a2 - OO
Architect /Engineer Address
Bonding Company Address
Mortgagor _ Address
Permit Type(circle one):'BUILDING ELECTRICAL
WORK DESCRIPTION / '2 ��/ �5& � Oh v
wasky nigeh;
Square Ft. 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
authorize the above -named contractor to do the work stated.
Sign wneP and /or Condo President
Date: /dv
d t,Q/ D d Donna P. Frantz t
„0� c , 11,il,;c, 6tat ri kc�Uda
Notary as to Owner and • • -' siRr_ . S rSG &u, <
`ao My COlnmissionlatP, 10/17/2001<
My Commission Expires:
NOTARY - Fla. Notary Senicn e: Bonding
* * *
FEES:
APPROVED:
tur of
owne APPLICATION FOR MIAMI SHORES VILLAGE
Zoning
(f Al atu? , 't ger5
NE /DO (1
sS# 2k/ - 74 -J Phone 305• ,f6P7-/4,7
* * *
PERMITk 1 RADON C.C.F. j'oZ
/1
Fire
Buildin
Mechanical Plumbin
Tax Folio // 3 20 4/3 24 Yl
Master Permit #
Phone 242 - 0 377
Address 30/ /7,95/8 (2)/ /v`°
MECHANICAL ROOFING PAVING PENCE &IGN
jtozi/C fa sev- ve_-
Date: 3 / /oo
Signature of Con % actor or Owner- Builder
cat•siWWAWc .:, cc«SmC4Cscm
• Donna Z`'. Frantz
Itary Public, Statf of Fiorillo
fl mi cinn hi
Notary as to Contractor or'`'Owiier-Euilder
';0T.4RY - F1a. Noter- S t
My Commission Expire n' = ondingco •
* * * * * * **
NOTARY TOTAL DUE
Other
Electrical
Engineering