1411 NE 101 StPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / Job Address 7.1 A/E /O/ • Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant C?-4.-1 P C�)-
Owner's Address 1 ' (l FMS t 0 1 Gv
Contracting Co. /" / /A , lf � /A 7 t
Qualifier C g€-..-L u✓ d��n �, F
Master Permit #
Phone 7S 7‘.
Address / 3 .1* ^' d 4'e. .
g 3s
1v33 - 16 5a,
State # C FC Oa S; 6 5 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / Ci� ( l-" - ' z �/^i C= �.Qv ✓� /1—i E_� '�-�
/-7
Square Ft. Estimated Cost (value) fi.SO6
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
law : lating construe tj,o and zoning. Furthermore, I authorize the above -named contractor o do the work stat • d.
Not
My C
a of ownerand/o ondo President 6
( • rc d/oii $d1NBEtAttiNNf JR
=n; 4,4 . EXPIRES: May 4, 1998
,t; °•'' Bonded Thru Ncdry p�Ge
FEES: PERMIT RADON
ate
ol
Signature of Contractor or Owner- Builder
otary s to
My Co ssio
i ‘e i C.C.F. l NOTARY
t- Owner- Builder
ELMER ZIMBELMANN, JR.
t . MY COMMISSION # CC 369069
EXPIRES: May 4, 1998
t; ` Bonded Thru Notary Public Undem t tens
TOTAL DUE /
Date
Date
APPROVED:
Zoning Building / . Electrical
Mechanical Plumbing Alt-, �• 1 / Engineering
Permit No._L ��___3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of wor
STATE OF FLORIDA,
COUNTY OF DADE.
• Owner's Name and Address
Registered Architect and /or E
Employing Plumber's Name
Location and Legal Description Lot
No._ 0 _
J Bloek
Street and Number where work is to be performed —No 1 4 / .1 / Street
State work to be performed and purpose of building (By Floors)________----------------_--_-___---
Remodeling —__ ______ Addition_______ Repairs___ No. of Stories.
Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ .!'1 1 I _ Street tfr ' ° l 1 1'4 4( '
--------------- - - - - -- -
/ v __ —____ — �_ -_ —_ — -
Amount of Permit $. /22 ( Signed) _
____
D6147) - 157-
Street- �!__.�!�(%
Notary Public, State of Florida
Size Septic Tank--------------------------------- - - - - -- Type of Tank
Feet of Drain Tile_._.___._ ___________ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply
Capacity Gals
Size of Soakage Pit
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 Compensation 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for 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'NB
WA"
vv
TOTAL
FIXTURES
CONTR.
LIST
1
7
CHECK
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c o
"S"
,�
2 _
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
$W IM'G
POOL
CONTR.
LIST
_LI
f
--
CHECK
/ 60
- �
-
Permit No._L ��___3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of wor
STATE OF FLORIDA,
COUNTY OF DADE.
• Owner's Name and Address
Registered Architect and /or E
Employing Plumber's Name
Location and Legal Description Lot
No._ 0 _
J Bloek
Street and Number where work is to be performed —No 1 4 / .1 / Street
State work to be performed and purpose of building (By Floors)________----------------_--_-___---
Remodeling —__ ______ Addition_______ Repairs___ No. of Stories.
Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ .!'1 1 I _ Street tfr ' ° l 1 1'4 4( '
--------------- - - - - -- -
/ v __ —____ — �_ -_ —_ — -
Amount of Permit $. /22 ( Signed) _
____
D6147) - 157-
Street- �!__.�!�(%
Notary Public, State of Florida
Size Septic Tank--------------------------------- - - - - -- Type of Tank
Feet of Drain Tile_._.___._ ___________ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply
Capacity Gals
Size of Soakage Pit
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 Compensation 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty
materials and /or workmanship.