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1301 NE 100 St (11)MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Reque Dat Type Insp'n Permit No. Name Address 1 3 Company Inspection Date Approved Correction Re -Insp' n Fee Approved Correction Re- Insp'n Fee MIAMI SHORES ILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildin: Inspection Request Date Type Insp'n Permit No. Name c 1 a. Address /30 Company Phone # Inspection Date r & loo f rkeep. _ q Coop )C RESURFACING POOL 7 Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP :155 Inspection Date: 04/25/2006 Inspector: Grande, Claudio Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: ESSIG POOLS INC Building Department Comments Monday, April 24, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: s RC2005 -91 Permit Type: Imported Permit Inspection Type: Final Work Classification: Pool - Private Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 305- 949 -0000 Page 2 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: .2005 -91 Printed: 3/18/2005 Applicant: PETER MARGOLIS Owner: MARGOLIS PETER JOB ADDRESS: 1301 NE 100 ST Contractor ESSIG POOLS Local Phone: 305 - 949 -0000 Parcel # 1132050140020 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: 1800 N. E. 151 ST. Permit Status: APPROVED Permit Expiration: 8/29/2005 Construction Value: $2,100.00 Work: RESURFACING POOL (MARCITE) Page 1 of 1 Legal Description: GORDON TRACTS PB 55 -20 TRACT B LOT SIZE SITE VALUE OR 18814 -0493 Fees: Description Amount FEE2005 -3495 Building Fee $160.00 FEE2005 -3496 CCF $1.80 FEE2005 -3497 Training and Education Fee $0.60 FEE2005 -3513 Technology Fee $4.00 FEE2005 -3514 Scanning Fee $6.00 Total Fees: $172.40 Total Fees: $172.40 Total Receipts: $0.00 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/18/2005 Applicant: PETER Owner: MARGOLIS JOB ADDRESS: 1301 NE 100 Contractor ESSIG POOLS Local Phone: 305 - 949 -0000 Parcel # 1132050140020 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2005 -73 MARGOLIS PETER ST Contractor's Address: 1800 N. E. 151 ST. Page 1 of 1 Legal Description: GORDON TRACTS PB 55 -20 TRACT B LOT SIZE SITE VALUE OR 18814 -0493 Fees: Description Amount FEE2005 -3515 Building Fee $160.00 FEE2005 -3516 CCF $0.60 FEE2005 -3517 Training and Education Fee $0.20 FEE2005 -3518 Technology Fee $4.00 Total Fees: $164.80 Total Fees: $164.80 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 8/29/2005 Construction Value: $600.00 Work: PLUMBING FOR POOL RESUREFACING 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed:3 /19/2004 Applicant: Owner: JOB ADDRESS: 10125 N MIAMI AVE Contractor BOBS SEPTIC & DRAIN INC Local Phone: 305 - 558 -5818 Parcel # 1132060131500 Plumbing Permit Permit Number: X2004 -91 Contractor's Address: 1020 NE 130 ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 11 LESS N3OFT & LOT 12 & N 5FT OF 13 Fees: Description Amount FEE2004 -2778 Building Fee $175.00 FEE2004 -2779 CCF $1.80 FEE2004 -2780 Notary Fee $5.00 FEE2004 -2781 Training and Education Fee $0.60 FEE2004 -2782 Technology Fee $4.37 FEE2004 -2783 Scanning Fee $3.00 FEE2004 -2784 Builders Bond $300.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $489.77 Permit Status: APPROVED Permit Expiration: 9/14/2004 Construction Value: $2,500.00 Work: INSTALL 200SQ DRAINFIELD SYSTEM Signed: (INSPECTOR) 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/19/2004 Applicant: Owner: JOB ADDRESS: 10125 N MIAMI AVE Contractor BOBS SEPTIC & DRAIN INC Local Phone: 305 - 558 -5818 Parcel # 1132060131500 Plumbing Permit Permit Number: PL2004 -91 Contractor's Address: 1020 NE 130 ST Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 11 LESS N3OFT & LOT 12 & N 5FT OF 13 Fees: Description Amount FEE2004 -2778 Building Fee $175.00 FEE2004 -2779 CCF $1.80 FEE2004 -2780 Notary Fee $5.00 FEE2004 -2781 Training and Education Fee $0.60 FEE2004 -2782 Technology Fee $4.37 FEE2004 -2783 Scanning Fee $3.00 FEE2004 -2784 Builders Bond $300.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $489.77 Permit Status: APPROVED Permit Expiration: 9/14/2004 Construction Value: $2,500.00 Work: INSTALL 200SQ DRAINFIELD SYSTEM 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: BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) A U ° C t., t/ C 44/ /U mitiq. AVC City /L5 State Owner's A dress ,/- 1i Tenant/Lessee Name D j//JJIJt/Z, Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES l / � �2 )ry ef�Cc 7 5 51 � Contractor s Company Name �6�,5 ��/ ' �,./ � ) Phone #/� / Contractors Address / , L() /0) t✓) / 3d 51 I City N, imp •• I State Zip 35).1 Qualifier 6 2 „ lititl Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition Describe Work: Total Fee Now Due $ (Continued on opposite side) Miami Shores Village- c, _ \; ,, 01 \\ Building De artme 10050 N.E.2nd Avenue, Miami Shores, Florida 3338 nr�c ❑Alteration Tel: (305) 795.2204 Fax: (305) 756.8972 /0 / 5 /V . in 4 , '9t ( County Miami -Dade Zip NO ['New Code Enforcement $ Structural Plan Review. $ Permit No. p1n 4- a� Master Permit No. Phone # Zip 3 3 f� Phone # 40.1'1 pCRO et yoga. Mechanical Roofing 331 Square Footage Of Work: Repair/Replace * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ❑ Demolition Submittal Fee $ Permit Fee $ 1 1 3.00 CCF $ i • ISO CO /CC Notary $ 5 Training/Education Fee $ 0 GO Technology Fee $ 3 Scanning $ • C)C) Radon $ Zoning Bond $ 300 • 00 r Bonding Company's Name (if applicable) Bonding Company's Address City 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 construction 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 COMMENCEMENT." 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) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Sign: Chc 12/15/03 Signa Owner or Agent n The foregoing instrument v strument was acknno edg�edbefore mee this ( day of r(.V"\ , 20 by ' l 9_Q. Q who is personally known to me or who has produced 1) (\U. NOTARY IC: State Signature TARY PUBLI Sign: Print: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. • Zip ontractor The foreg ' g instrument was acknowledged before me this I day of YC_.V I ; 20 Q, by (2p t t 11G , who is personally known to me or who has producedD t&:QJ ?Os d ar : s As identifica 14 �v ASt , s;lre:i rli , I� _ � I I = � ires: Jul 4 , f ,' ' �c f illn ` ' I L • 4, Ong o., Inc. Bonded Thw Print: � � � �� at JL■ My Commi Expir 911,4nd Matairl tVergagath. Commission #DD231984 xsi ::Ju 3,2007 My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** *,*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED 0 / Plans Examiner t Engineer Zoning 03/12/2004 15:09 3055133472 OSTDS STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT REPAIR LOT: 11 BLOCK: 11 SUBDIVISION: Miami Shores (Section /Township /Range /Parcel No.) PROPERTY ID #: 11- 3206 - 013 -1500 [OR TAX ID NUMBER] PAGE 01 CENTRAX #: 13 -SG -19979 DATE PAID; FEE FAID : $ RECEIPT OSTDSNBR : 04- 0949- -R CONSTRUCTION PERMIT FOR: [ ]New System [ Misting System ( )Holding Tank ( ) Innovative Other C B ]Repair ( )Abandonment [ ]Temporary ( NA ) ___.... APPLICANT: Liddle, Elie & Noel AGENT: SR0921116, PARXLLA ROBERT PROPERTY STREET ADDRESS: 10125 N Miami Ave Miami FL 33150 SYSTEM MUST SE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E- 6,FA,C DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY TRF. PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OP THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T ( 750 )Gallons SEPTIC TANK MULTI CHAMBERED /IN SERIES: [Y ] A [ 0 ]Gallons MULTI- CHAMBERED /IN SERIES: (Y ) N I 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K ( 0 ] GALLONS DOSING TANK CAPACITY [ 0 ) GALLONS @ [ 0 ]DOSES PER 24 NRS # PUMPS [ 0 ] D [ 200 ]SQUARE FEET PRIMARY D,RAINFIELD SYSTEM R ( 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ] STANDARD [ N ) FILLED ( N )MOUND [ N ] I CONFIGURATION: [ N ]TRENCH [ N ]BED [ N ] cr F LOCATION TO BENCHMARK: 12.11' . mag At P.F. of Exist. Eldon. I ELEVATION OF PROPOSED SYSTEM SITE [ 8.4 ] [ PEET ] [ BELOW)BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 38.4 ] [ PET ] [ BELOW) BENCHMARK /REFERENCE POINT D FILL ,REQUIREDD! [ 0.0 ]INCHES EXCAVATION REQUIRED! [ 36.0 ] INCHES OTHER REMARKS: House 2 bedrooms; Built in 1952 Site elevation: 11 -4' ngvd RSWT contour map: 4.0' msl Install 12" of slightly limited soil under the bottom of drain field Invert elevation: 9.4' ngvd Bottom of drain field: 8.9' ngvd SPECIFICATIONS BY: e4/(—IV L. APPROVED BYc Lo ea, DATE ISSUED: 3/12/04 DH 4016, 03, (Dbso.lets previ TITLE: TITLE: editions which may not be used) EXPIRATION DATE: C/10/04 ■ BUILDING PERMIT APPLICATION FBC 2001 Tenant/Lessee Name Permit Type (circle) Building Electri Owner's Name (Fee Simple Titleholder) t, Owner's Address /30/ ,QE /QV S7L City : � 1 ` 5/a4ta State Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 R( CE V1 ZD R 2 . 2005 Plumbing Zip / 30/ /VC /tic/ -' Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES ' O Contractor's Company Name Contractor's Addres / City 64 Qualifier Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ['Addition Descri Work: ILQ 34;4'. Submittal Fee $ Scanning $ Code Enforcement $ (Continued on opposite side) s Total Fee Now Due $ (1 0 - 00 State �L- 2, /0D ❑ Alt County Miami -Dade Z i l e Phone # 2 r 5 V Permit Fee $ Radon $ 10._ ❑New Notary $ Training/Education Fee $ Zoning Structural Plan Review. $ Permit No. aster Permit No. ZG9S Mechanical Phone # .33/313 Phone # Zip Square Footage Of Work: tgr Repair/Replace CCF $ CO /CC e7 [ee MAR 2 7 PAID c z_ 4- (0 4,4- Roofing Zip ❑ Demolition Technology Fee $ Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State 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 construction 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 COMMENCEMENT." 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 posted at the job site for the first inspection which occurs seven (7) days after the building permit is •issued. !c of such posted notice, the inspection will not be a.. oved and a reinsse tion fee will be charged. �, i Signatur I lk Signature , - weer or Agent The foregoing ins trument was acknowledged before me this day of ,'1/4.du l , 20 66, by who is personallykri tome w o has produced ti i n and who did take an oath. Y PUBLIC: � 2 007 NOTAR APPLICATION APPROVED BY: Chc 12/15/03 sk ERMAN i min tractor The foregoing instrument as ac owledged before me this aq day of J71/dl� , 20. �°. who is persona y known to as identific NOTARY PUB . C: � ; 'I + ta r p0 , � i���� ► SH Sign = -�, Sign = .ire �G� =� omm e May 24, v '� tic, State of Florida Print: n Print: m.140.1/0 182405 ... ... - ► ay 49 2007 My Commission Expires: �prptp� I. N. DD 182405 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** My Commission Expires: a produced ho did take an oath. Plans Examiner Engineer Zoning BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): lectrical Owner's Name (Fee Simple Titleholder) kw_ (A LCZ t_IS Owner's Address (301 IUD- loo ST City tit ttyht SNcat State F LD Oct Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) 1 30 k L E too 51 City Miami Shores Village County Miami -Dade Zip '5313K Is Building Historically Designated YES NO Contractor's Company Name 551(:, PbOLS 1 N C. Contractor's Address 1$00 &J 15 1 S 1 $ Value of Work For this Permit Type of Work: Describe Submittal Fe Notary $ Scanning $ Total Fee Now Due $ Addition (Continued on opposite side) Permit Fee $ Training/Education Fee $ •*----*-- Radon $ Code Enforcement $ /i7t '7 Miami Shores Village `- _11 ❑Alteration a * * * * * * * * * * * * * * * * * *** * * * * * *F a Co O Zoning Structural Plan Review. $ Permit No. Master Permit No. Plumbing Mechanical Phone # 305 Z1 l 2.. 33138 t ''"" 0 2 20n5 Phone # o5 c y c - 0000 City J . ON . t (.t State ((C.CrZI Zip 3310 Z Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ❑New ❑ Repair/Replace ❑ Demolition \ ovr at ) ** * * * * * * * * * * * * * * * * * * * * * * * * ** n co/cc Bond $ CCF $ Technology Fee $ Bonding Company's Name (if applicable) - Bonding Company's Address City State 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 construction 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 COMMENCEMENT." 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 commenceme - . t be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the . e of such posted notice, the inspection will not be approved and a rein pection fee will be charged. Signature NOTARY PUBL Sign: Print: My Comm Chc 05/13/03 • Is: ss APPLICATION APPROVED BY: produced nd who did take an oath . exp. Ma 24, 2007 Cng7m N .._ ""�` PO 8 2405 Signature y known as identificati er or Agent The foregoing instrument wa cknowledged before me this 7 The foregoing instrument wa owledged before me this day of /t - Theell , 20D�,_by — , day of rim QF , 206' who is person who is pers Print: My ntractor e_or wl Pg duced o i /ho did take an oath. KENNETH SHERM NOTARY PUBLIC: ta ller K E om ission Expires: (nary P omm. No May 24 200, ************************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * 1 ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * ** ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 0 Plans Examiner Engineer Zoning RMAN of Flow 4 Scale 1"=30' (n 1- U FIP 0 1/2" e V (No I.D.) 0.6' o/s North Q 0 0.7' o/s West (\j I 1 U a z to � 0 0 K) 4 LC) U 0 J m S 1— 0 Z - FIP0 1/2 (No I.D.) cb bib' O 1.7' E ots N 0 °09'06" W 79.73' (r&m) LOT 7 GORDON TRACTS ( 55 - 20) NI G P 1 ` — - Eound Nail ti 0.6' o/s South . n o /s�Tes D = 00 °00'x" _ :..:.... Found Nall 63.78' 0s' o/s South = 48.22' 1:9' ols'Eas S -0 °21'36" E 6 ;® (r8►m 30.0' FIP 0 1/2" (No 1.D.) abl 0 FIP 0 1/2" (No I.D.) Patin 5 �� NE 1991 ' GONG 22.0' '0 .0' Paton 0 0.8_ GRAVEL DRIVEWAY .:,- -- Found Nail. 4' 0/5 North ` 0.7'. o/s East N.E. 13th AVENUE 4 .j 20' ASPHALT PAVEMENT W I 4: W • I o x ■ o 0 a J ✓ � a PROPERTY. 1301 NE 100 DESCRIPTIC Traci E " G to the Plat it Page 20 of County . Fin There may bt property that Survey that n of Miami -Dad public and pr may appear. The Map of S at the stated measuremen that said dra% the reprodud This survey v of a BOUND, intended to d of any federa board, comm Legal descril Legal Descril limitations, re easements. If shown elev Well- identifie measured to foot unless of The elevation survey and m accuracy of 1 for hardscapt man -made fe FLOOD ZON Community Panel No. 00 Suffix: J FIRM; Date: Flood Zone: `t �ME 991 X s * AERIP )RESS: 3T REET vr!;',M . 1"i„ 33138 DCJfd T ?5 ` according )of as recordGo' in PI u: 55 �r Public Records of - OADE lal restrictions on the subject not shown on the Map of be found in the Public Records ounty, or the records of any other entities as their jurisdictions ey is intended to be displayed )hic scale in English units of ltention is brought to the fact 1 may he altered in scale by process conducted for the purpose SURVEY only and is not :ate the regulatory jurisdiction ate, regional or local agency m or other entity. was furnished by the client. I subject to any dedications, :tions, reservations or recorded is are referred to N.G.V.D. of 1929 itures as depicted on this survey and map were stimated horizontal positional accuracy of 1/10 vise shown. well- identified features as depicted on this vere measured to an estimated vertical positional foot for natural ground surfaces and 1/100 foot faces, including pavements, curbs and other as as may exist. FORMATION: 120G52 RAP (NOT TO SCALE) .e. r 1. N, E. /O/ sr. ST, GOROO)? SHORES (ss - .91 I 7 I N.E /00 ST.. :kJ) w.al r•,e a•to..r/i,r r rc i Cur4O1.• ra +w,.4,w, �wr �r ry +•w SEC e, S Hews 1 't1 , 44 , LOCATION MAP (NOT TO SCALE) The surveyor makes no representation as to ownership, possession or occupation of the subject property by any entity or individual. Subsurface improvements and /or encroachments within, upon, across, abutting or adjacent to the subject property were not located and are not shown. Not valid without the signature and original raised seal of a Florida Licensed Surveyor and Mapper. Additions and deletions to this Map of Survey by other than the signing party are prohibited without the written consent of the signing party. This Map of Survey has been prepared for the exclusive use of the entities named herein and the certification does not extend to any unnamed party. CERTIFY TO: Peter W. Margolis & Nancy A. Cigno Washington Mutual Bank, FSB, ISAOA -ATIMA Norman T. Roberts, P.A. Chicago Title Insurance Fund Inc. Attorneys' Title insurance Fund. Inc. SURVEYOR'S CERTIFICATION: I hereby certify: That this "BOUNDARY SURVEY" and the Map of Survey resulting therefrom was performed under my direction and is true and correct to the best of my knowledge and belief and further, that said "BOUNDARY SURVEY" meets the intent of the "Minimum Technical Standards for Land Surveying in the State of Florida ", pursuant to Rule 61G17 -6 of the Florida Administrative Code and its implementing Rule, Chapter 472.027 of the Florida Statutes. BAEZ & ASSOCIATES, INC. Florida Certificate of Authorization No. LB 6356 Oscar E. B. z- Cusido, P.L.S. Register Surveyor and Mapper No. 5034 State of Florida. BAEZ & ASSOCIATES, INC. Land Surveyors - Land Planners E 2000 S.W. 83rd Court MIAMI, FLORIDA 33155 PHONE: (305) 265 -1002 FAX: (305) 265 -0608 05 -06 -2004 ORIGINAL 02 -05 -2004 FIELD DATE REVISIONS: up -dated 05 -06 -2004 J a o z 4 4 d 9 c s &— • Q w 2 W C d' K 1n N Vf V) 3 LL LL LL z J LL JOB NO 9312 -1321c DRAWN J.C R • H Ul z w O 3 Is s Z tu z z z u II II fl II U II II „ „ „ „ „ „ „ O vi m m = • a a m • • u uu SHEET I/1 I C I LO Passed Inspecto m ents Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until - inspection IVurrrber�1NSP`'1'531`3 Inspection Date: 04/20/2006 Inspector: Levrack, James Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Contractor: ESSIG POOLS INC Building Dep artment Comments Friday, April 21, 2006 Miami Shores Village, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: 73 Permit Number: PL20051' Permit Type: Imported Permit Inspection Type: Final Work Classification: Pool - Private Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 305 - 949 -0000 Page 1 of 2 us BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building lectrical Plum 'ng Mechanical Roofing Owner's Name (Fee Simple Titleholder) �� . ' Phone # Owner's Address / 30/ %, /7 Zip ,31 City i P ,./t7/: State Tenant/Lessee Name Phone # Contractor's Company Name Contractor's Address City V,. Qualifier $ Value of Work For this Permit Type of Work: — Describe Work: Scanning $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) ES:52 Miami Shores Village Building Department 10050 N.E Auie� ' • Shores Florida 33138 Tel: 56.8972 /30/ AIE /0a Permit No. aster Permit No. ?L Z�.S 73 Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO - S/ Sri State P‘.— Zi Architect/Engineer's Name (if applicable) Phone # Notary $ Training/Education Fee $ Radon $ Zoning Structural Plan Review. $ Phone # (S05 /) / Square Footage Of Work: ❑New Repair/Replace I Submittal Fee $ Permit Fee $ 1 Co ` .- a - CCF $ CO /CC ❑ Demolition Technology Fee $ Bond $ --ennic( I COE MAR 2 7 PAM Ctt i0 144- Bonding Company's Name (if applicable) Bonding Company's Address City State 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 construction and zoning. 1• "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 RE CORDIN G YOUR NOTICE OF COMMENCEMENT." 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) days after the building permit is• issued. In th• ss; -nce of such posted notice, the inspection will not be as roved and a reinspection fee will be charged. web— twner or Agent The foregoing instrument was acknowledged before me this day of 4 2 4 , 2004 , by who is perso NOTAR Sign Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. APPLICATION APPROVED BY: Chc 12/15/03 ho has produced , day of who is person andwhodidtakeanoath. sHERN, NOTARY PUBLIC: AiV �► _ ` HEpn,, N P i Sign: iYo' 0 1;4- �M A 'V coin ; 24 , 21 Print: My comet, . ; a e of Fl orid a 82405 007 (Certificate of Competency Holder) y kno -me or , o)has produced as identifica on ■ actor The foregoing instrument was acknowledged before me this ', 11 1 OO 'by My Commission Expires: Certificate of Competency No. who did take an oath. „omm, No. DD 182405 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Compa y a (", me Lq p3Z ( . Contractor's Address / DOE /5 / City ia Y ,, (.Q G ,' - / — _ State Qualifier ban tg $ Value of Work For this P rmit Submittal Fee Notary Scanning $ Total Fee Now Due $ (Continued on opposite side) Permit Fee Training/Education Fee $ Radon $ Miami _ , O Village Building Department , t 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Owner's Name (Fee Simple Titleholder) P( r- I J VI VV) 1 ( C Phone # 2S — Z( / 2_ Owner's Address I, 1 �-t 10 0 � City vn Lova j k e C State P Zip Tenant/Lessee Name Phone # 3?? 2 o t E l op .0-- 6b 0 County Miami -Dade * * * * * * * * * * **p * * * * * * * * * ** *F * * * * ** Zoning Code Enforcement $ Structural Plan Review. $ Permit No. P/t — 73 Master Permit No. Zip 33f a J � Zip 331 to 2 Square Footage Of Work: r CI Phone # 30S-9(0 (0 ^ Cb(9 * * * * * * * * * * * * * * * * * * * * * * * ** CCF 0/CC Technology Fee $ Bond $ nical Roofing State Certificate or Registration No. aft Certificate of Competency No. Architect/Engineer's Name (if applicc1e) , --- Phone # Type of Work: EAddition L, ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: ; vt S +0A1 sk-%iv. r*j W O..∎ diVireZt Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 construction 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 COMMENCEMENT." 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 brochur• will . • delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commences t m 'st be posted at the job site for the first inspection which occurs seven (7) days after the building perrnit is issued. In the a '. en. • of such posted notice, the inspection will not be a. •roved and a reinspection fee will be charged. S dA ignature Signature wner or Agent The foregoing instrument was acknowledged before me this / The foregoing instrument wa day of _ ` � , 20 .. by day of 7/74 who is per : ally know >. :: o produced who is per n and who did take an oath. NOT Sign: Print: RMAN m. exp 44 24 Florid. *************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Comm NO * * * *1w440500i My C. fission Expires: ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * ** ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 State Zip State ' Of Florida omm ea ;vfaY2� Zip Comm. No, DD 182405 2007 NOTARY P Sign: Print: My C I �. . 1 mission Expires: ally know y e or as iden ' ati actor owledged before me this L A triIi�il►IJIZ • ry pub/lc I ir pr oduced 0 did take an oath. 7 - Plans Examiner Engineer Zoning rs Date 2.- Z 3 O Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL OWNER'S CERTIFICATION I certify that I am the legal owner of the property described as , located at t 30\ (OR' CO SI M t,q.,, Z t4wzt5, (SL 3 3 i 3 In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Note: This certification is to be submitted with a swimming pool permit application in duplicate. BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Value of Work For this Permit, 3 V - 0 Type of Work: ❑Addition ❑Alteration Describe Work: /1/ 4 g1 , (/ per / 5 Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ❑New Permit No. n ' cf "6 9 Master Permit No. Mechanical Owner's Name (Fee Simple Titleholder) Phone # Owner's Address City State Zip Tenant/Lessee Name / 3o 1 A42 /0051 County Miami -Dade NO Phone # Contractor's Company Name Alt / /d,Il "Ce-Ce f.'/ Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ❑ Repair/Replace * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ 6 — Permit Fee $ 1 3 /v ._ Notary $ Training/Education Fee $ . (() Q Scanning $ Radon $ Zoning Code Enforcement $ Structural Plan Review. $ r t_s Zip CCF$ I 0 Technology Fee $ 3, Bond $ CO /CC Roofing ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State 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 construction 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 COMMENCEMENT." 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) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _ , by , day of , 20 by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 12/15/03 _ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ( 1Ob50 4.k: Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972 Dat FL 2 (�U' 2 F 1 idresi ,ZbOA \00,7C' Leg scrip ion �tYXAt— caner ssee/Tenet l--e Master Permit #L-� D \ 1 6 Owner's Address 1 ‘ is X40 ►171 Contracting Co. �MnA Qualifier —13 : ) (4 , / Q._0 Wi-- SS# " ' Phone 8)5— 'I State # Municipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 550.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL ( PLUMBING) MECHANICAL ROOFING WORK DESCRIPTION: ■ +fi r^• 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 ANY 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 all disciplines. 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 to do the work stated. Signature of owner and/or Condo President \.e . ba - cAM48..• JOEL COHEN 14;4 n Notary ner Rl699ig@vj n � My Comeswit,f4xpirast swim & Bonding SD , o o -41- 33 FEES: PERMIT /go RADON C.C.F NOTARY BOND APPROVED: Zoning Building Mechanical I Plumbing Date Tax Folio Historically Designated: Yes No Phone /D3S s ) 7 c ri c i8 Address 1 \'i d0 61u ftA.o Sk-+wf me/ P: alt k SA-4 vv% new' Li .A1 Date Signatu of Contractor or Owner Builder C -ct+v•• I • cl,. (14mtidbt661SSt • Y �Q; Sion E#131 ' ^:June 25. 2005 1.800. 3-NOTARY FL Notary Service & Bondi ate ate TOTAL DUE Electrical Structural Engineer Contractor ALL FLORIDA POOLS Local Phone: 305 - 893 - 4036 Parcel # 1132050140020 Plumbing Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -69 Printed: 3/3/2004 Applicant: MARGARET Owner: BARCHAN JOB ADDRESS: 1301 NE 100 ST BARCHAN MARGARET Contractor's Address: 11720 BISCAYNE BLVD Legal Description: GORDON TRACTS PB 55 -20 TRACT B LOT SIZE SITE VALUE OR 18814 -0493 Fees: Description Amount FEE2004 -2251 Building Fee $130.00 FEE2004 -2252 Technology Fee $3.25 FEE2004 -2261 CCF $1.80 FEE2004 -2262 Training and Education Fee $0.60 Total Fees: $135.65 Total Fees: $ 5. Total Receipts: $0.00 J ,Q- 1 ES- 4 -S Permit Status: APPROVED Permit Expiration: 8/22/2004 Construction Value: $2,800.00 Work: INSTALL NEW RETURN LINES, SKIMMER BOX AND SKIMMER LINE Page 1 of 1 e 33 Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle) Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simp : i _ • er) 7?C 1, 0/.$ Phone # Owner's Address /45::57 A/ g --- / �Y-- City , 1 / `S e 5 State ��¢" Tenant/Lessee Name Phone # Job Address (where the work is being done) / /f/z /O0 City Miami Shores Village County Miami -Dade Zip is Building Historically Designated YES NO 3 6-_ 3 y 5"_ G 3 fPfR :. 4`- Contractor's Company Name COM , d s e Phone #6 o. ,. OVVX7 City { State Qualifier Contractor's Address $ Value of Work For this Permit l /f✓ State Certificate or Registration No.CCG OC) 0/0 Architect/Engineer's Name (if applicable) Phone # / g am Master Permit N Zip 3313e Zip 33)3° Certificate of Competency No. Square Footage Of Work: ECEVED AL16 1 6 2004 a�ao GB Gla .1111 Permit No RPny• 11l Type of Work: ❑Addition ❑Alteration ❑New ❑ Re air/Re 1 ce ��----�� p p � [2] Demolition Describe Work: �> 4 5 k I ****************************F Submittal Fee $So, c)-6 Permit Fee $ /1 - CCF $ an CO /CC Notary $ Training/Education Fee $ C O Technology Fee $ / 50 Scanning $ 3 Radon $ � Zoning ' Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State 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 construction 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 COMMENCEMENT." 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) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatu Owner or Agent The foregoing instrument was acknowledged before me this day of NOTARY PUBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: Chc 05/13/03 ,20,by who is personally known to me or who has produced As identification and who did take an oath. Contractor The foregoin instrument was acknowledged before me this day of , 20C C", by aP 4+t/ who is personally known to me or who has produced identification and who did take an oath. ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** NOTARY PUB Sign tit AU6 19 2004 AI FRFD txni ree;. it ..;.� ,,, Bonded By Na; .. ******************************** **** * *** ****** * * * * * * * ** * ** ** *�k ' * ********* * ** * * * ** ** * * ***** ** * ** ** **** * ** Plans Examiner Engineer Zoning Z4 Scale 1 " =30' to W O 2 to 4 F rQ co 1— U o Q O J ce m � — H O 1— J Q J a_ 0 W 0 Z W Q �O FIP 0 1n• 1. (No I.D.) 0.6' o/s North 0.T o/s West Y U 0 - CO w Z J J ui of 0 u x 1.7' - - SIP 0 1/2" (No I.D.) 1.r -found Nail 0.6' o/s Soulh .V Ws West... D = 00 °00'00 "._.._. ::::: :: : : : : - Found Nab R - 63.78• o.a soon, A = 48.22' 1 9' o/s East .: S -0 °21'36" E 6 N 0 °09'06" W 79.73' (r &m) LOT 7 GORDON TRACTS ( 55 - 20 ) UltRiVON Or SUM - -30.0' FIP 0 1/2" (No I.D.) .Found Nail �8ifY1 • 0.4' o/s North ; o.r o/s East N.E. 13th AVE T 20' ASPHALT PAVEMENT W a / W r re g PROPERTY ADI 1301 NE 1000 DESCRIPTION Traci B G 0 t0 the Plat thetr Page 20 of the County FIOridp There may be let property that are Survey that may of Miami-Dade C public and private may appear. The Map of Survi at the stated graf measurement. AI that said drawing the reproduction ce O This survey was of a BOUNDARY intended to deline of any federal, st< board, commissic Legal description Legal Description limitations, restric easements. If shown elevatior Well-identified fea measured to an e: foot unless otherm The elevations of • survey and map N accuracy of 1/10 f for hardscape surt man -made feature FLOOD ZONE INI Community No. 1 Panel No. 0093 Suffix: J FIRM Date 07.17 Flood tone. AE + AERIAL A Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -1130 Printed: 8/19/2004 Applicant: PETER MARGOLIS Owner: MARGOLIS PETER JOB ADDRESS: 1301 NE 100 ST Contractor FLORIDA PROFESIONAL SERV LTD CO Contractor's Address: 100 NE 89 ST Local Phone: 305 - 759 - 3460 Parcel # 1132050140020 Signed: (INSPECTOR) Building Permit Permit Status: APPROVED Permit Expiration: 2/13/2005 Construction Value: $1,800.00 Work: POOL COPING/TILE/DIAMOND BRITE Page 1 of 1 Legal Description: GORDON TRACTS PB 55 -20 TRACT B LOT SIZE SITE VALUE OR 18814 -0493 Fees: Description Amount FEE2004 -8454 Building Fee $100.00 FEE2004 -8455 CCF $1.20 FEE2004 -8456 Training and Education Fee $0.40 FEE2004 -8457 Technology Fee $2.50 FEE2004 -8458 Scanning Fee $3.00 Total Fees: $107.10 Total Fees: $107.10 Total Receipts: 0.00 s l AIN 24 PAID 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: BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA Date -r` ` 19 fig° ELECTRICAL ❑ PLUMBING o PERMIT N? 10562 Contractor's f l ROOFING ❑ License No Owner of .. Building 4 "- ❑ Work to be performed under this Permit ••• • 1.. Architect 4 r c" ,-, Contractor or Builder i r t`` ,, 4 a + z" � Legal Lot 11 Description 11 BI. Address of Buildin g / 5 ti / r.• /rte 4 , Building 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 applica- tion 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 statements or specifications and that he assumes respon- sibility for work done by his agents, sere is or employees. Signed- ;:".4.- a ' ; ` i < s ` �' ,` ( I N S PECTOR) BY In consideration of the issuance to me of this permit I agreeo perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawing "; or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit.- I�assume responsibility for all work dott either, myself, my agent, servant or employee. CONTR/!<CTOR or BUILDER 3 Subdi- vision Sq Ft of 11 Amount of Project $ 11 Permit $ BY AUTHORITY BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING 4n PERMIT N? 10319 ROOFING ❑ Owner of Building "* Architect ° t+i 4404 Contractor ~ or Builder Legal Lot 11 Description 11 Bl. Address of �� Building 1 C I -' C` C i 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with anc 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 o ..drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants, employees. u y�� a Signed "L../"' - 0..' �► f" °� ` t oNIPECTOR In consideration of the issuance to me of this permit I agre pertaining thereto and in strict conformity with the plans, drawin In acceptii this permit . I : sume responsibility for all work do CONTRACTOR or BUIL]YER Work to be performed under this Permit L,:; F f .fie► r- '� w f . c Subdi vision' .4 c 7 "�+ alt. r.- Sq Ft „,.,, CPC) Value of 11 Amount of .,.. Project $ 11 Permit $ perform the work covered hereunder in compliance with a 1 b' inances and regulations tatements or specifications submitted to the proper authorities of Miami Shores Village. y either, myself, my agent, servant or employee. woo BY" B Date I Contractor's License No "�++' 1 9'.!1 Permit No.. -__ ._ r _ °_ S-60. 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. - -_ Jae_ -- /! V Z . No._L 3 O / - - - -- —_ Streeti . _ Registered Architect and /or Engineer._. . C%Bni //12e °/(,c_ Employing Plumber's Name ___ No.__ 8'O > — — - Street?? Location and Legal Description Lot ----- • -. . _ .__ —..___ _ -__ - - -._ Block.._ Subdivision. _. - ... Street and Number where work is to be performed —No /2 ©/ _ Street e,- .. /� - S7/7; State work t o be performed and purpose of building (By F l o o r s )- - - - - - - - �C�.¢T.4. - 4vAg _ - -- / f d . New Building Remodeling_ ____ _.__ ____ Addition._._ - - Repairs_- . -..... _ _ - -. No. of Stories Size Septic Tank. _ Type of Tank Feet of Drain Tile._ Nature of Water Supply: City —Well. Amount of Permit $ ---- •__v._ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT STATE OF FLORIDA, I COUNTY OF DADE. Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati •s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent plement, 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 no•ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, o , ork to be perfo!.tled and , this per nit, as are licensed by Miami Shores Village. (Signed Date _�d. ~_Z _ .._ --- - -.... / 6Q .s.7; Gtioc lambing In.pecto. _ /l /J Master Plumber. n� Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall.• 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 .acts 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. ■ CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TOSS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT - NS TOTAL F`XTURE6 CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LI ST CHECK Permit No.. -__ ._ r _ °_ S-60. 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. - -_ Jae_ -- /! V Z . No._L 3 O / - - - -- —_ Streeti . _ Registered Architect and /or Engineer._. . C%Bni //12e °/(,c_ Employing Plumber's Name ___ No.__ 8'O > — — - Street?? Location and Legal Description Lot ----- • -. . _ .__ —..___ _ -__ - - -._ Block.._ Subdivision. _. - ... Street and Number where work is to be performed —No /2 ©/ _ Street e,- .. /� - S7/7; State work t o be performed and purpose of building (By F l o o r s )- - - - - - - - �C�.¢T.4. - 4vAg _ - -- / f d . New Building Remodeling_ ____ _.__ ____ Addition._._ - - Repairs_- . -..... _ _ - -. No. of Stories Size Septic Tank. _ Type of Tank Feet of Drain Tile._ Nature of Water Supply: City —Well. Amount of Permit $ ---- •__v._ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT STATE OF FLORIDA, I COUNTY OF DADE. Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati •s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent plement, 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 no•ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, o , ork to be perfo!.tled and , this per nit, as are licensed by Miami Shores Village. (Signed Date _�d. ~_Z _ .._ --- - -.... / 6Q .s.7; Gtioc lambing In.pecto. _ /l /J Master Plumber. n� Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall.• 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 .acts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made 'when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. ■ R c BUILDING gi PLUMBING ELECTRICAL ❑ PERMIT N? 10318 ROOFING ❑ Work to be performed under this Permit Owner of = t Building �" a' ' ' . 0 Architect 7,1 t *, i Ic"' ice. * a5$ e)C Contractor or Builder p+ l C.. 4. l !a' it k C.: Legal Lot � � . ' Description � ( Bl Address of l _ � Building Signed• MIAMI SHORES VILLAGE, FLORIDA *a I. • " 84-4 Date. 19 Contractor's CP344or t.. License No. goo se 3 aim * If ., / 4 1 • 4 0 e , - . Subdi- 77;4C1 t" s vision 643. 41. 4 1`a C i I Sq Ft Value of „.t • 11 Amount of 4e, Project $ 11 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 applica- tion 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 statements or specifications and that he assumes respon- sibility for work done by his agents, servant r emplocee"s. 4" (INSPECTOR BY In consideration of the issuance to me of this permit I agr to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawi , statements or specifications submitted to the proper authorities of Miami Shores Village. In acceptin is permit I assume responsibility for <all work do by either, yself, my agent, servant or employee. CAL CV 0.4 CONTRACTOR or BUILDER BY AUTHORITY.` MIAMI SHORES IV LLAGE BUILDING INSPECTION 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_ .._&. r Owner's Name and Address Q( �?��!_� No 13 6i Street_ eo. - Registered Architect and /or Engineer *W L/.2 -94s , :stJr1e Name and address of licensed contractor eee - 2a6 'l 'C $'Q7 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done /. 2/ 22t_ ' /46/_S22 State work to be done and purpose of building (by floors) 6 OP/ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of ..LL i-! e Kind of foundation Roof Covering m Estimated Total cost of improvements $ ‘ d Amount of Permit $ 2A:) 1 - 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 STATE OF FLORIDA, 1 COUNTY OF DADE. j ss. PARTMENT c7 B NING BOARD DATE ,e / 77'4 c 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 sub «. itrac • 'n . irk to be performed under this permit, as are licensed by Miami Shores Village. `� Remarks (Sign Before me, the undersigned authority, a notary public, duly authorized to administer oaths an ; t. 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 / a 3 / 6" Date Disapproved _ Date (Signed) Building Inspecto Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires Chairman 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. 1' Application is hereby made for the approyal 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 BUILDING INSPECTION DEPARTMENT !T O.Q 'e/ MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Date -- - 1� ` 2 No._ /._4/ Street_ Notary Public, State of Florida ( Signed) Building Inspector My Commission Expires ,1 96 77 Registered Architect and /or Engineer S,7 �°.e_d Name and address of licensed contractor .P.�LrC - 2-, Yc' f 8 7J. <d __.... 'et o tu QGe cf , Location and legal description of lot to be built on: Lot Block Subdivision ?'1347`7". 8 0 6 c 04 ,./ Ti ?;44' Street and Number where work is to be done ,Vic?/ �.r__ l 7 C Si J " State work to be done and purpose of building (by floors) ./ele_G__.____._ ,/_OQ-d 1 (. M 3 4 ss_n.L_[_� �aa� C a v « c 1 - - -- and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of_ e lLL _ Kind of foundation Roof Covering Estimated Total cost of improvements $ 6e2o_o ` Amount of Permit $ 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 fo in ectio •n the si : , the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such bco ac .rs, on ork • be perf9n ed under this permit, as are licensed by Miami Shores Village. 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. Disapproved Date PLANNING BOARD DATE Chairman 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. Permit No. ___ .l_ O _ -_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt 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_ , .0-C_- No. 3O/ _ - Street.. 7 . - . /CW S7 Registered Architect and /or Engineer __... LS 9- S( _li �/ Pa' Employing Plumber's Name __. ____. Location and Legal Description Lot-_ _9_.s Street and Number where work is to be performed —No l O' State work to be performed and purpose of building (By Floors)_ New Building - •___ -- __ —_ Remodeling - - -- __ -_ Addition__ -- - _ Repairs- _ - -... _ - -.. No. of Stories _ Size Septic Tank Amount of Permit $__ STATE OF FLORIDA, COUNTY OF DADE. 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 - -- r 9SS�c°r N o . Block_. Suubdivision -.at &c h69!___ Street__ / .. - - � - -._. ..... . (Signed) Date _01-e" ._Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat . as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen . upplement, and I:as 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 no'ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo :11,ed under this per nit, as are licensed by Miami Shores Village. Plumbing In;pecto. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 •acts 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. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FI %TORES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHICK Permit No. ___ .l_ O _ -_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt 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_ , .0-C_- No. 3O/ _ - Street.. 7 . - . /CW S7 Registered Architect and /or Engineer __... LS 9- S( _li �/ Pa' Employing Plumber's Name __. ____. Location and Legal Description Lot-_ _9_.s Street and Number where work is to be performed —No l O' State work to be performed and purpose of building (By Floors)_ New Building - •___ -- __ —_ Remodeling - - -- __ -_ Addition__ -- - _ Repairs- _ - -... _ - -.. No. of Stories _ Size Septic Tank Amount of Permit $__ STATE OF FLORIDA, COUNTY OF DADE. 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 - -- r 9SS�c°r N o . Block_. Suubdivision -.at &c h69!___ Street__ / .. - - � - -._. ..... . (Signed) Date _01-e" ._Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat . as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen . upplement, and I:as 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 no'ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo :11,ed under this per nit, as are licensed by Miami Shores Village. Plumbing In;pecto. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 •acts 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.