1235 NE 100 St (8)Legal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address /a.5 A/& x011 Tax Folio 11 ,52.05 0 8 040.S
,d121 - ? - / Gordon shores
Owner / Lessee / Tenant .zoo/t5 27), - 7;01.15_s
Owner's Address /2,3 V /e & Phone
Contracting Co. c R /Q-S 6,4 �f Address 1 %/e/ 644 1)5x,4, - i'
Qualifier /6 1 g SS4# - - Phone 94 04259
State # Municipal # Competency # Ins.Co.
Architect /Engineer e 7 7 69791 67-e c Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION "(.51Z 6/ X ' 1? la e;?_,Zo'ce ', ) t'
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.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * * *
FEES: PERMIT elli RADON C.C.F. !_ NOTARY TOTAL DUE J 4
APPROVED: Fire Other
Zoning Building Electrical
Mechanical Plumbing f�!� / Engineerin
Signatu
Date:
Master Permit it 3 51% 1 1
6 900
er- Builder
Notar Contra c or (g Omer- Builder
My Co ission epi es:
**
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1. LOCATE MW PROTECT ALL UTILITIES IN AREA OF
CONSTRUCTION. UNCLE ;41- 300.432 -4770
2. RESTORE ALL AREAS TO PRIOR CONDITION.
3 ALL ;OI'S' U! :TON TO FOLLOW JURISDICTIONAL
GOVERN ,1ENT PO P;;S STANDARDS.
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1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF
CONSTRUCTION. UNCLE #1-200-432-4770
-
2. ;;:✓ O E ALL AREAS f•
•- hxtAS TO PRIOR CONDITION.
3 ALL ;n.SJRUCT;ON TO FOLLOW JURISCICT IONA.1
GOVERNMENT AND PCS STANC
DATE
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1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF
CONS:RUC:HON. UNCLE #1-800-432-4770
2. K3TORE ALL AREAS TO PR!OR CONCITION.
3 ALL !;+wit + ^7? r - ..
RUM TO FOLLOW JURISCICTIONA1
GOVERNMEOT AND STANC.ARDS.
DATE
3 -2/ - 5/
SHEET
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A.F.E.o /Oi)0000 to z
Date
PERMIT APPLICATION FOR °MIAMI SHORES VILLAGE
3l//7 Job Address /0Z3$ ///f / ' S' Tax Folio
Legal Description
Owner / Lessee / Tenant 6 .;
1235 J1/cs / )
Contracting Co. �f �d ati77A- c.M�`.s!
r SS#
Phone f � �G j7(1)
# it I ns.Co.
Address
ary as to
My CommissiopbT
MY
BO
* * * *
9y
CHANICAL ROOFING PAVING PENCE SIGN
Estimated Cost(value)
er- Builder
TE OF FLORIDA
EXP. APR. 1,1994
GENERAL INS. UND.
uilder
FEES: PERMIT RADON C.C.F. A5 NOTARY TOTAL DUE t
*
Other
Electrical
Engineerin&
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1 7. 3
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.-: elkialtIft5 1 1C1!�____ No. —_ Street
Registered Architect and /or En ineer_______
Location and Legal Description Lot
Street and Number where work is to be performed —No
Date
0640/76
�rn4NO Plum bers Name1l��'L . _
Employing
,g Block G �___ ---- __ Subdivision ._ -- --------..... -- ........
_._
(�' G •� S I!/L -�.��
Street__
- " work to be performed and purpose of building (By Floors)
e V New Building I 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._______ _ ._._Size of Soakage Pit
Amount of Permit $ 4
The undersigned applicant for this building permit does hereby certify that he understands and accepts his orations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent 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 tlie Act. The undersigned agrees to employ only such sub- contractors, o» work to be perform under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, } as,
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 he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Plumbing Inspector.
( Signed
Capacity Gals
eta 444,e6A
Master Plumber.
CLOSETS
BATH
TUBS
C/ ,�L �
SHOWERS
. i
LAVA-
TORIES
3
SINKS
INKS
I
SLOP
SINKS
LAUNDRY
TUBS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
3
CHECK
p /� /
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE i• �� ►�
TRAP HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
J L
kV{GTP+e
6C/ ✓glee
CONTR.
LIST
CHECK
1
..6.C7
/
- -_—
Z'S
3`.=,
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1 7. 3
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.-: elkialtIft5 1 1C1!�____ No. —_ Street
Registered Architect and /or En ineer_______
Location and Legal Description Lot
Street and Number where work is to be performed —No
Date
0640/76
�rn4NO Plum bers Name1l��'L . _
Employing
,g Block G �___ ---- __ Subdivision ._ -- --------..... -- ........
_._
(�' G •� S I!/L -�.��
Street__
- " work to be performed and purpose of building (By Floors)
e V New Building I 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._______ _ ._._Size of Soakage Pit
Amount of Permit $ 4
The undersigned applicant for this building permit does hereby certify that he understands and accepts his orations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent 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 tlie Act. The undersigned agrees to employ only such sub- contractors, o» work to be perform under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, } as,
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 he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Plumbing Inspector.
( Signed
Capacity Gals
eta 444,e6A
Master Plumber.
Permit No._
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLgc TION FOR PLUMBING PERMIT
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
Registered Architect and /or Engineer____—__ — ____-- _-____ - ,_ - -_
Employing Plumber's Name er IN r'D _ 7 u 5� ^ / _ _ No._ .1.. e.s2L1 SIAL2.L._. Street -.
Location and Legal Description Lot
Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)____
New Buildiag___ - -- __ .- .......--- ._______ Remodeling____-__ .... _______ Addition
Amount of Permit
Size Septic Tank__
Feet of Drain Tile.
STATE OF FLORIDA,
COUNTY OF DADE.
_Type of Tank___ Capacity Gals
_- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply City - Well.____ _ _____________ 71 _ __Size of
(Signed)_ _ - -
(Signed)
Pit
Subdivlsf
Date -- - -- ° r - /r7 - ..
Street
Repairs No. of Stories. _ .._.... __... _ .
My Commission Expires Notary Public, State of Florida
........... _
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanen pplement, 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 work to be performed under this pennit, as are
licensed by Miami Shores Village.
Master Plumber.
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 he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp' n, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
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
SW IM•G
POOL
CONTR.
LIST
CHECK
■
_
Permit No._
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLgc TION FOR PLUMBING PERMIT
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
Registered Architect and /or Engineer____—__ — ____-- _-____ - ,_ - -_
Employing Plumber's Name er IN r'D _ 7 u 5� ^ / _ _ No._ .1.. e.s2L1 SIAL2.L._. Street -.
Location and Legal Description Lot
Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)____
New Buildiag___ - -- __ .- .......--- ._______ Remodeling____-__ .... _______ Addition
Amount of Permit
Size Septic Tank__
Feet of Drain Tile.
STATE OF FLORIDA,
COUNTY OF DADE.
_Type of Tank___ Capacity Gals
_- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply City - Well.____ _ _____________ 71 _ __Size of
(Signed)_ _ - -
(Signed)
Pit
Subdivlsf
Date -- - -- ° r - /r7 - ..
Street
Repairs No. of Stories. _ .._.... __... _ .
My Commission Expires Notary Public, State of Florida
........... _
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanen pplement, 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 work to be performed under this pennit, as are
licensed by Miami Shores Village.
Master Plumber.
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 he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp' n, or faulty
materials and/or workmanship.