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1217 NE 100 St (10)Date /44 rn Legal Description °L / Lessee PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address / Tenant MRS , J,# M F=S . e L, F'f O R D Owner's Address / 2 1 7 N E 100 State #C,C00g533Municipal # Architect /Engineer N/A Bonding Company /V 1 /4 Mortgagor ,JU! "1 Address Permit Type(circle one): BUILDING /217 Ai. 100 5r Tax Folio //- 3 or-190 63J Master Permit # / •�� Phone 751- & O'7 Z Contracting Co. ✓©N 3 `OoL/ N L, / /N C. Address 1 3 33 3 AJ I) 7/416 Qualifier eo E'R L . k)DLFo gD Phone 4. $S-g62 Competency # Ins.Co. Address Address ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTIONgXPIQT kF. PLAC M ENT SAME � / 512G 5AM / F / L.oaAFT ; 0 Ai 1) 3T'o n► l O oiu P, UN i r ' 7'o n� 1�1� U L✓� i i� /C �iJ S T R / C = ,si ( Square Ft. Estimated Cost(value) ost(value .2 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. Signatu Date: / owner and /or Condo � "ir '/ tip K U RQ/lJ it Nc#tary as to Condo President My Commission Expires: NOTARY PUBLIC, STATE OF FLORIDA. MY COMMISSION EXPIRES: April 1, 995. ** * * BONDED* RU NOTARY PUBLIC UNDERWRITERS. esident * * * FEES: PERMIT 4 RADON C.C.F. A SO APPROVED: Plumbing_ Signa Date: ntra r Owne ilder o!1416(3 A �„� . Not y as to Contractor or Owner- Builder My Commission Expires: NOTARY PUBLIC, STATE OF FLORIDA. MY COMMISSION EXPIRES: April 1, 1995. * "NDED THSU NOTARI UBLIC UIrERWRITE F Ph NOTARY TOTAL D UBS'I� 6 J, ±uRPou Fire Other 4 Building Electrical Engineering TIM ATH TUB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS • UNIT FEE IOET .LIGHT OUTLETS CENTRAL HEATING ISHNASFER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEMPORARY A/C (CEO) RIN(ING FOUNTAIN SERVICE SIZE IN AM DUCT WORK LOOK (DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION ' REASE TRAP - APPLIANCE OUTLETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNDER9 0U10 TANKS AVATORY OVEN ABOVE GROW TANKS AUNDRY TRAY • WATER HEATER U.F. PRESSURE VESSELS LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS MOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS IN(, POT/3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION INK, RESIDENCE ACTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES IN(, SLOP . MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS EM'ORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS RINAL MOTORS OVER 25-100 HP COOLING TOWERS ATER CLOSET MOTORS OVER 100 HP VIOLATION NDIRECT WASTES A/C WINDOW REINSPECTION ATER SUPPLY TO: A tR -COHO I T I ONERS f?i K 6J C P g A/C U • STRIP HEATER - TR I Fi47` FIRE SPRINQER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL • SPECIAL PURPOSE SWIMMING POOL OUTLETS C0I$ERCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS TILITY -SEWER SIGN TIME CLOCK MITT -WATER FIXTURES - EPTIC TANK ANTENNA :LAY TELEVISION OUTLETS U I If IELO, 4' T ILE/RES. VIOLATION IP & ABAIOON SEPTIC TANK RE I NSPECT I ON . AWE PIT CU. FT. . ITCH BASIN I SCH A RGE WELL IMEST I C WELL REA WAIN • • XIF MEET 1AR WATER HEATER - IRE STANDPIPE XUL PIPING • • ON SPRINKLER SYSTEM 4S RANGE :TER SET (GAS) • 4S PIPING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR.B$ILDIIG PERMIT MUST ACCOMPANT THIS ADDENDUM. I! A MASTER PERMIT HAS BEEN OBTAINED, THE OVNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.), PLUMBING ELECTRICAL MECHANICAL ' yi 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 This( E 1 9 Owner's Name and Address._..._. F W Ski L S 0 R � No Street Registered Architect and /or Engineer Name and address of licensed contractor.. fVef / d,' �i i✓ `�� �`�� Q Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1 2-- 1 ^ 1 /�`" / ® 0 i , Gr State work to be done and purpose of building (by floors) A._L__f3....C.C.Yt..=_/_1_. f_I_A.. 3�3.L_x7.5 and for no other purpose. New Building X . Rernodeling. Addition Repairs No. of Stories To be constructed of Kind of fo ndatio Roof Covering Estimated Total cost of improvements $._. Ge Amount of Permit $. .__Ctl - x..dn� 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 pennit 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. .� Remarks (Signed) 0 - -_ 19.5 y STATE OF FLORIDA, I 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 Read, Sworn to and Subscribed before me. Disapproved ............... . . .. Date (Signed) Notary Public, State of Florida Building Inspector My Commission Expires PLANNING 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. PHONE 9 -8752 MaehnIIthI RIM' goiD malaumna too MANUFACTURERS OF RESIDENTIAL AND COMMERCIAL AIR CONDITIONING SSE c'7 /Y Zo .vf/ 41/ F l: o z% 0-55,,,„d- * 7 * * MIAMI 35, FLORIDA Gevi je.--t-6/(44 c,71 0 z_ l ? BUILDING ELECTRICAL PLUMBING ROOFING Address of / -7 Building 1 MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT N? 7378 ISJ Owner of Building =' ` '" Architect Contractor / or Builder : -' Legal Lot Description — Bi. Work to be performed under this Permit Subdi- vision Value of Project $ DATE 195 Contractor's License No. Signed �� � ./2/7 / . /' ' 4 BY INSPECTOR Amount of , Permit $ 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 shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. / , 1 . 1 1.41 ,. ,I .+ 4 CONTRACTOR OR BUILDER BY AUTHORITY 13 ,. BUILDING ELECTRICAL PLUMBING ROOFING ;, ar Owner of c- Building `- -' ' L & S Architect Contractor or Builder f►'t �► Legal Description Address of Building Lot /21'! 4 MIAMI SHORES VILLAGE. FLORIDA 0 ❑ PERMIT ■° 4485 Contractor's ❑ - License No ! ! d 0 fl Work to be performed under this Permit j \t ok t � This permit is granted to the contractor or builder named above to construc 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 autho - ' on. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for . thorough owledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or s fications and that he assumes responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER Bl. Signed. Sf W _C i BY 5 c ; Subdi- vision Value of Project $ *Z t7' INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work cove .d 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. I i' DATE I '-' t ,195( Amount of 4 Permit $ AUTHORITY c 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. Owner's Name and Address ... ..`��.A Registered Architect and /or Engineer Name and address of licensed contractor M Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT L - , ..4& .irk, A-3 - 3 `I LI State work to be done and purpose of building (by floors) 1 A t' ■& and for no other purpose. New Building . s Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ - ...J. Amount of Permit $ Z • S C 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 subcontractors, on work to r-be performed un es this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss • Date 1 - , 19 � No 5 / 2 Street. -..N • 4. / Z A v at a./ •� lr�c 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 .._4 4 '_') Date I ' - i 7 - j Read, Sworn to and Subscribed before me. Disapproved Notary Public, State of Florida (Signed) Building In ector My Commission Expires PLANNING 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.