16 NE 100 St (10)Date 024_ 1 Job Address T Iii NE: 1C7 = Tax Folio
Legal Description Ux%
Lessee / Tenant VJIL.LA 1MAA:M7 J Master Permit # 3 7
Nv too Vii• Phone Z r6- ZC.Z / 5 ig/W04r
Owner's Address
Contracting Co. /)2' /)ce...,..oee Address
Qualifier SS# - - Phone
State # Municipal # Competency 41' -
Architect /Engineer
Bonding Company Add'
Mortgagor Add__
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION escre UO6L P41tJrmkv l a„ ,E 5 WR( rti' TO W!-ltTE:
Square Ft. L'Jv14 Estimated Cost(value) D..1
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.
Ail
Signature of owner and /or Condo President Signature of Contractor or Owner Builder
Date: Date:
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILL A.GE
* *
* *
Notary
My Commiss
FEES: PERMIT 37, SID RADON C.C.F. NOTARY
c.)14‘te.,
O /- z -95"
as to Contractor or Owner- Builder
OTARY SEAL
INES RAMIREZ
NOTARY PUBLIC STATE OF FLORIDA
CO1MISSIOHi NO. CC.?R4094
MY COMMISSION EXP. AUG. 1,199
**
136
TOTAL DUE 3 d.
Fire Other
Zoning Buildin Electrical
Mechanical Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
Work to be performed under this Permit
Owner of
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 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 or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed• ��- /x+ • BY .,c—
�! 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 responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 10321
Bl.
Subdi-
vision
Value of
Project $
y 0
i y1.
DATE /
Contractor's
License No.
Amt. of
Permit $
BY AUTHORITY
195
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ./ � -- __ - -' . , � Date 1 / ]J /-/
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 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 C A''a" i e S No Street
Registered Architect and /or Enginer
Employing Plumber's Name 9,414_4_
Location and Legal Description Lot It ft
Street and Number where work is to be performed —No ./
State work to be performed and purpose of building (By Floors)
44.4. No 1 3 g
Q 11 ? f / Block
tc
[7.vis°✓rt
Street A ! 1#'
Subdivision 2 /
Street • l°O
[j.Gdt�tov�„
v
• t �.
New Building Remodeling Addition Repairs No. of Stories
Type of Tank__ e€414. Capacity Gals 5 �~
Size Septic Tank 510 6
Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
Amount of Permit $
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensatio, Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
ss.
(Signed) ___a.
STATE OF FLORIDA, t
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
Master Pluinber.
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.
I _.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
0
/ u
I L- .�L�
TOTAL
FIXTURES
C L
LIST
1
/
/
/
...o;
.7,---
CHECK
qq
J
i ®
7,4' ‘)
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
t // _ _ T _
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ./ � -- __ - -' . , � Date 1 / ]J /-/
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 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 C A''a" i e S No Street
Registered Architect and /or Enginer
Employing Plumber's Name 9,414_4_
Location and Legal Description Lot It ft
Street and Number where work is to be performed —No ./
State work to be performed and purpose of building (By Floors)
44.4. No 1 3 g
Q 11 ? f / Block
tc
[7.vis°✓rt
Street A ! 1#'
Subdivision 2 /
Street • l°O
[j.Gdt�tov�„
v
• t �.
New Building Remodeling Addition Repairs No. of Stories
Type of Tank__ e€414. Capacity Gals 5 �~
Size Septic Tank 510 6
Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
Amount of Permit $
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensatio, Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
ss.
(Signed) ___a.
STATE OF FLORIDA, t
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
Master Pluinber.
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.
I _.
7
• /