185 NE 100 St (17)•
4.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ot Job Address t S r N E Op S 1 - Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenan 0..r1O, ` G. G RI FF (tJ Master Permit # 572g
Owner's Address ri5 Iss E. 100 co - r -
Contracting Co. KENO 4 I I S J 'Hi F&Y) c e A )tAddress /l0 / ,sr S c<1 // 7 A, 4-7
Qualifier oN/9 O • ...45j/Ht. ss# Phone 3oj = zr3 is
State # Municipal # Competency # de / 3 ✓`08' Ins. Co.
Architect/Engineer /v /� Adder
Bonding Company A/ //9 Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN
WORK DESCRIPTION 5 -et LQDA fli J Q
P e PC727 J ./ ".1.&- J
l
Square Ft. c LP" Estimated Cost (value) / „? L ) Z
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.
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
co on and zoning. F • ermore, I authorize the above -named contractor to do the wo k stated.
APPROVED:
Zoning
Mechanical
er and/
ssion Expires PRISCILLA PUENTE
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC646727
MY COMMISSION EXP. MAY 25,20J1
FEES: PERMIT ✓ 6 , RADON
Building
9
Phone 30C 1 - t q
as to Co
My Commis
Electrical
%or Owner -t" 1 �,
YAV, -- Shirley J. Cooper
November 27,1999 MY COMMISSION # CO511990 EXPIRES
of F6 BONDED THRU TROY FAIN INSURANCE, INC.
dD
C.C.F. / • NOTARY BOND
TOTAL DUE (5/, °a
SIGN
Plumbing Structural Engineer
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ONE STORY
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Date of t1etd,.•ork: 05/21/99
Completion date: 05!24/99
Survey number: a-20012
The EasO K of Lot 21 Iled all of Lot 22. Stodc 15, of AN AMENDED
PLAT OF MIAMI SHORES SECTION NO.1 aoaxding to the Plat
thereof, as recorded in Nat Book 10, Page 70, of the Public Records of
Miami Q.de County, Florida.
Certified to:
Randy G. Griffin; Richard Omaha, P.A.; Mtorneys Title lutur .tc
Fwd, lac., its suocessoesandlorassigos.
Propeity Address:
185 N.E. 100 Street
Miami. Florida 33138
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Owner's Name and Address__&1
Registered Architect and /or Engineer �.r1�Sr�Lthre
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot 2 -24,__2. 1 Block_ ! 3 -_____ Subdivision
Street and Number where work is to be done ./ill
State work to be done and purpose of building (by floors)
New Building _ .�jj, Remodeling___..
To be constructed of 15dN4.Ct - - Kind of foundation_-_
`0
Estimated Total cost of improvements $____ 0 0
Zone cubage required
Distance to next nearest building__ Q_
Maximum live load to be borne by each °or__
and who, being by me first duly sworn, up
of the above described construction, that
therein by him st.. are pe. -
Permit No
Disapproved ____________________ D
(Signed)
Chairman
Member
Member
Council
Approved
Date
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
•
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the 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 regula-
tions 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.
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 be understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performe uncle t ;s
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized
appeared – -- -- -- — —
ath deposes and says that is the
care „lly read the foreg g application, and that he did sign the same, and that all facts
dition Repairs
Roof Covering
Amount of Permit $
Plan Cubage______ ''LL
Size of Building Lot _�.�_5L___
(over)
Date/
PLANNING BOARD DATE
Member
Member
- -- — — 19-
-- Street_
Member
Date Disapproved
to administer oaths and take acknowledgments, personally
6 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
__and for no other purpose.
No. of Stories
to me well known,
_ —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.
1 General Building Contractor.
LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC.
- REQUIRING OCCUPATIONAL LICENSES
MIAMI SHORES VILLAGE
2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting.
3. Electrical.
4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank' and Drain Field.
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior), Painting, Waterproofing, Damp - Proofing and Paper- hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors.
14. Roofing, Sheetmetal and Skylights.
15. Solar Water Systems.
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile,. Terrazzo, Marble, Granite and .Cut Stone.
20. Electric Fixtures.
21. Illuminated Signs.
22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, .Association or other organization engaged in the bus-
iness of supplying, furnishing or. delivering building materials for any construction project within the
Village Limits and not having a regularly .established and licensed place of business in the Village.
Owner's Name and Address
__ ' - -
I
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
and who, being by me first duly sworn, upon,
of the above described construction, that he h
therein by him stajd are rue
A,10
Permit No 611 Date
Disapproved
(Signed)
MIAMI SHORES VILLAGE
Building Inspector
D
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the 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 regula-
tions 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.
Registered Architect and/or Engineer________4_—
Name and address of licensed contractor__________________
Location and legal description of lot to be built on:
LotAg B1ockJ Subdivision
Street and Number where work is to be done ILJ /
Datez , 19_
_
; T
______ _ Street_
State work to be done and purpose of building (by floors) ______1_4r
__and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories _
To be constructed Kind of ___ _ _________ _ _______ __________ Roof
Estimated Total cost of improvements _____ _________Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building_ Size of Building Lot / 1 5
r
Maximum live load to be borne by each floor_
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. . /- • L
K 27 1.!!.
Remarks (Signed) f a ' i fii ( /,' t-
/ ..,.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
ath deposes and says that is the
caref lly read the foreg g application, and that he did sign the same, and that all facts
(over)
0 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
to me well known,
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved_ Disapproved __Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval bas 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.
LIST OF CONTRACTORS, SUB = CONTRACTORS, ETC.
REQUIRING OCCUPATIONAL LICENSES
MIAMI SHORES VILLAGE
1. General Building Contractor.
2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting.
3. Electrical.
4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank and Drain Field.
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper - hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors.
14. Roofing, Sheetmetal and Skylights. .
15. Solar Water Systems.
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile,, Terrazzo, Marble, Granite and Cut Stone.
20. Electric Fixtures.
21. Illuminated Signs.
22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus-
iness of supplying, furnishing or delivering building .materials for any construction project within the
Village Limits and not having a regularly .established and licensed place of business in the Village.
\447-