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171 NE 100 St (9)Date APPROVED: Zoning Mechanical Contracting Co. /4c L Qualifier ' 1 11% State # 1 000 (' My Commission Expires: OD Job Address /7/ lrJf /de, < Tax Folio I J O b l O� t I FEES: PERMIT 5 rmd RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Plumbing Legal Description P ! 7 a / 7 Y- 0 ( //,2 Owner/Lessee / Tenant T& 1 / 0 56 Owner's Address c_ e Address 0 kJ l� g i ss# (). 0 5 Mumcipal # Competency ti 000 t72 O Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING LECTRICAL) PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN ��qq WORK DESCRIPTION K/Euv4 f frie. Square Ft. Estimated Cost (value) 4 v50 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 wi 1 be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to wor, ettr, -c)//A, s7./7/C7 Signature of owner and/or Condo President Date S i: do o��� •� er- Builder Date Notary as to Owner and/or Condo President Date Notary as C.C.F. NOTARY Phone Building Electrical Historically Designated: Yes No Master Permit # 7 • `'r a i• ARY SEAL My Co ssion xpir soL CRUZ NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC 879569 MY COMMISSION EXP. OCT. 3,2003 BOND TOTAL DUE 7//f/oc7 Date Structural Engineer ITEM BATH TB UNIT 0 FEE ITEM SWITCH OUTLETS • UNIT FEE ITEM SPACE HEATERS UNIT FEE BIOET LIGHT OUTLETS CENTRAL HEATING OISI ASTER RECEPTACLES A/C (WADI) DI SERVICE TEMPORARY A/C (CENTRAL) :KINKING FOUNTAIN - SERVICE SIZE IN AMPS DUCT WORK =LOCK DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION 2REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS _AVATCRY OVEN ABOVE GROUND TANKS ..AUNORY TRAY WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTORS 0— 1 HP STEAM BOILERS S H DWER MOTORS OVER 1— 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3— 5 IP _ MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5— 8 IP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8— 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS IRINAL MOTORS OVER 25.100 HP COOLING TOWERS 9ATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW RE INSPECTION CATER SLPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER 4 GENERATORS TRANSFORMERS HEATER —NEW INST. GENERATORS TRANSFORMERS HEATER — REPLACE GENERATORS TRANSFORMERS LANK SPRINKLER —WELL SPECIAL PURPOSE SWIMMING POOL o OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS ' TILITY —SEWER SIGN TIME CLOCK TILITY —WATER FIXTURES _PTIC TANK ANTENNA :LAY TELEVISION OUTLETS 1AINFIELO, 4' TILE/RES. _. VIOLATION M & ABANDON SEPTIC TANK RE INSPECTION )AKAGE PIT CU. FT. %TCH BASIN ISCHARGE WELL :M(ESTIC WELL LEA DRAIN . OF INLET ;L AR WATER HEATER RE STANDPIPE AL ' PIPING WN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL T 1 /g fit( • 1 FEES: PERMIT Date `legal Description Owner/Lesee / Tenon Owner's Address PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address `1/ t �'( WE- t. S Tax Folio i Historically Designated: Yes No X Contracting Co. X fgEr>17 6-1 fit, / (— gruzA Qualifier " / 1 . — 1`" fig — State # CG-C- A- / g Architect/Engineer G�. �:� �►� • � ;:, — "4 a-1 t OM Signature of owner an or 'ondo = -• ident APPROVED: Zoning Vd" Mechanical Plumbing Municipal # Date SS# Address 7 /Z 6 . 4- ' & L i-L, / ) ? ?2 -$' / Competency # Address Address 1 Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION .,()r P r f '- \ Tr DelAcraa -ck til'' ocISTIkic 02Muctai f . O kocto .C -" c . a Square Ft. •°' Estimated Cost (value),/ Q,�"° Address 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 m 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 wo# will be done in compliance with all applicable laws regulating construction and zo ' g. uthorize the above -named contractor to do the wo ed. S;gnat Notary as to Owner and/or Condo President No My Commi io Expires: My =mission Expire p zo l ?3 yS P74-0 04 5rA d e . ' // ct OPFICIAL NOTARY SEAL .> GLADYS J VILLAR ',NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 - e 0 5 / BOND Q o � yt�4iSS1[)N F.R. 12 h1� J NOTARY Master Permit # 1 y 5r) 3 ® t B 3 DS- 50S Phone 306 C _,P Aa,T L Ins. Co. 7//2./n ontractor or Owner - Builder Date IC 6/6-660- /3. OD/ -0 Ds q_12-o0 as to Contractor r Own6WRICida&NOTARY SEAL ` Date GLADYS J VILLAR NOTARY PUBLICSTATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR. 1,2002 TOTAL DUE Electrical ///'. Structural Engineer NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION / 0i rR469216 2000 SEP 27 13:03 PERMIT NO. TAX FOLIO NO. 1/- .� D6 - ,/3 470 6 0 STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: is i 2. Description of improvement: 3. Owner(s) name and address: 17- AJi4 Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expira on date of this Notice of Co _ , ent: (the expiration date is 1 year from the date of recording unless a different ate is specified) 1 Signature of Owner Print Owners Name Sworn to and subsc Notary Public Print Notary's Name My Commission Expires: ed before me this2? day of NOTARY PUBLIC STATE OF FLORIDA C* �.. • 1. • � COMMISSION FXP. IvtAR l 2oOD STATE OF FLORIDA, COUNTY OF DADE I HEREBY CERTIFY that this is a true co. re original tiled in this office on �� y of , A D 20 CIO WITNESS my hand and (scot Seal. HARVEY RUVIN, CLERK, of Circuit and County Courts By 5 . �—� other documents may be served as provided Prepared by:), Lip Address: ij( )jr It .c J S lig(4 3r 123.01 -52 2/93 PERMIT NO. ADDRESS: . MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBUC WORKS STRUCTURAL • JOB ADDRESS / 71 /U /V s APPLICANT PHONE # APPUCATION It SHEET OF • MISCELLANEOUS DATE CRITIQUE SHEET 74 1e95 , e. lv.ccae cit POOf 14/t • BUILDING OFFICIAL I. Subject to compliance with eat Federal. State. Cady, Village rules and regutations. Vitiate assumes no responsibility for accuracy otter resutts from these plans. 2. This copy of plans must be available oa building site or no Inspection wail be conducted. Z, oolu (iv6 COMMENTS INITIALS ®o . t u / T' (5 Pr/t)//1 ez e: ' t,o' (sJ PE o Piaeas7, 8,t7 4Qq\( or (address) 1'(( 100 < i from the Building and Zoning Department on (date) to have corrections done to plans and/or get County stamps. I understand that the plans need to be brought back to Miami Shores Building and Zoning to continue the permitting process. Signature BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES, FLORIDA 33138-2382 TELEPHONE (305) 795-2204 FAX (305) 756-8972 RECEIPT contractor /owner, picked up 2 sets of plans for 7 °7;6 t� �N MT- . - EcaE 77 EUiLDENG AND ICNING 10 G 5 N. I. end H ICE (305) 795 -220 FIX: ( 7-97 BUILDING PERlfI': /C NIRALTORS BSISI ATTCN =LIST v Copy of STATE OF FLORIDA c'IC ATION (DPER) : _ STATE REGISTRATION AND DADE CC UNTY CC2iPETENCY LIC SE. Croy of , .r C CUPATICIAL LIC 7S ==car cow: or municipality whe)-e business is located. / Certificate of Insurance for LIABILITY (addressed to Miami Shores Village). Certificate of Insurance for BR'S COMP (addressed to ShoresVillage) or if exempt. b' State of Florida Lc , Form BCf -204, Construction. r 6.us ri Notice of Election to be Exemot. PLEASE SUBMIT EVERYTHING C KED OFF IL Permit Application (signed by person performing the work, licensed contractor and the property owner, both signatures notarized). ///// No sets of plans /drawings signed and sealed h r registered architect or engineer. Occupancies by Group Classification must be on plans and permit application. All plans must include folio number and property address. Amended plans, in addition to the above, must also include the permit number. Structural Calculations signed and sealed by architect or engineer when /applicable. Current survey of the property. V Certificate of Elevation signed and sealed by surveyor. Substantial Improvements Checklist (omt `ctor or owner) . t! Temp sets of energy calculations Two sets of signed & sealed Truss Plans (Engineer). DADE County or State of Florida Products Approvals for roof materials, sheds, windows, exterior /garage doors, aluminum c.rorts, screen enclosures, shutters awnings, skylights, french :tors and etc. P_provals fran H S,. DADE County. Impact Fee Section; Fire Department & Health Department (when applicable) . DER`r //4 /1/6x) / „. 5 - Warranty Deed or Other Proof of Ownership if necessary. Structural Review fee Flood Elevation Notice of Commencement ui (7zs N� l67 5f .alermo Avenue C FLA. 33134 — O AD (305) 444 —7692 BRWD (305) 779— 3288 FAX : (305) 441— 6494 wd% iI) t'S • ca-. 3.4' /iO5'N — N /— 5 /or'y 52 0, fees /o 3 A. Czi Al a 20 Ca/ L / //, 2 /. / Q• . 1 . THOMAS J. KELLY, INC. LAND SURVEYOR SKETCH OF SURVEY SCALE I" = /�d a0 /7/ . /a.1/) INS /J /YiJ Q :. �a so • N Ti /c A ......t ,,: ...r. +ten .;,, .... • /(23: •. 75.00 a11) s' S /dars /.? /2.53 CC (2 7 cz. • V) a//. Qyii1� ;; �s. SURVEY NO 2 ' 73 SHEET 2 7 . OF G ,Palermo Avenu �.uRL1L GABLES, FLA. 33134 DADE • (305) 444 -7692 BRWD• (305) 779- 3268 FAX : (305) 441- 6494 3.4 ///7' \� N \ 5ed lV�s /def7c /Q • /7/ /e2io •o /5 /U' tv N G .� 20 ' l4t • N W 9 ' k THOMAS J. KELLY, INC. LAND SURVEYOR SKETCH OF SURVEY SCALE : I =/2.© • 75.00 - le4) 5/6/e‘ua /• • • , � - ,P, l %a ■ ST U) ti SURVEY �N 2754' SHEET 'L OF 2 ID PottuMA 97a cos % (address) (q1 0(-5 (00 mil' Signature to have corrections done to plans and/or get County stamps. I understand that the plans need to be brought back to Miami Shores Building and Zoning to continue the permitting process. BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138 -2382 TELEPHONE (305) 795-2204 FAX (305) 756 -8972 RECEIPT contractor /owner, picked up 2 sets of plans for from the Building and Zoning Department on (date)