258 NE 100 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Dal /.!C (20 STtgc i Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant qj Q8SR - 7- s q,,,.,..,.o 4.t s / fide" /A.S+JA/ Gs Master Permit #
Owner's A d d r e s s /) Phone 7.5'1 2 ( 7
Contracting Co. WI 1 J4t-/ We l t t l/ i l U1 i Address 013 A1 ) 492.O 7,4, X 3 05 5
Qualifier h L I t7 GD'OOa 't 7/ SS# - Phone 3e3S (02-1 34/94/ V
State # [ 005- qj too Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL LUMBIN MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
1�
/340
S gnature of owner and/or Condo President Da
Z14
to o0
Notary as to Owner and/or Condo President
My Commissio; Tires:
Harold A Cole • ' !:! ' , MY CO MMISSION # CC709308 EXPIRES
January 20, 2002
•• • 0‘ .' BONDED THRU TROY FAIN INSURANCE, INC
FEES: PERMIT Li RADON
Competency # Ins. Co.
Address
Address
Square Ft. Estimated Cost (value)/ 35D. a 0
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 wor ; . tated.
C.C.F. 6 NOTARY
v /''x171
of Co or or Owner - Builder ate
/400
Notary as to Contractor or Owner - Builder D e
My Commission Ee4; Harold A Cole
, rh ':.: MY COMMISSION # CC709308 EXPIRE§
,'. - °a; January 20, 2002
' a • °P' BONDED THRU TROY FAIN INSURANCE INC
BOND r/ //
k0
TOTAL DUE ,.."5 ,$ 2
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Jttr C'S LPLIPlcck 1 Structural Engineer
re(ry r S l g >7 ec( (/7pp/'c.l',
Permit No IePV
Owner's Name and Address 4_19_4_3.
Registered Architect and /or Engipeer_ �Employing Plumber's Name
_ __ Size Septic Tank___ Feet of Drain Tile___ — Nature of Water Supply: City —Well.
Amount of Permit $_
STATE OF FLORIDA, COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
k Tan
___ No.
(Signed)_
Date - a` -- i zei�'p
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
Street
Street_-
Location and Legal Description Lot �j Ir,t Subdivision______.____
Street and Number where work is to be performed —No 6
State work to be performed and purpose of building (By Floors)_
New Building--__ ______ ........ ._____ Remodeliing______- ______-__-__ Addition_
Repairs No. of Stories.
Capacity Gals.
__Dist. Feet o ank or Drain Field from Well
-Size of Soakage Pit
,,,
k
Plumblit Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an/ ployer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supple nt, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im 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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
SHOWER!
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
- - --
CHECK
Permit No IePV
Owner's Name and Address 4_19_4_3.
Registered Architect and /or Engipeer_ �Employing Plumber's Name
_ __ Size Septic Tank___ Feet of Drain Tile___ — Nature of Water Supply: City —Well.
Amount of Permit $_
STATE OF FLORIDA, COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
k Tan
___ No.
(Signed)_
Date - a` -- i zei�'p
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
Street
Street_-
Location and Legal Description Lot �j Ir,t Subdivision______.____
Street and Number where work is to be performed —No 6
State work to be performed and purpose of building (By Floors)_
New Building--__ ______ ........ ._____ Remodeliing______- ______-__-__ Addition_
Repairs No. of Stories.
Capacity Gals.
__Dist. Feet o ank or Drain Field from Well
-Size of Soakage Pit
,,,
k
Plumblit Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an/ ployer of labor
under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supple nt, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im 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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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.
Permit No. _
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 No. Street
Registered Architect and /or Engineer
Employing Plumber's Name. _ ' No Street
Location and Legal Description Lot Block Subdivision__
Street and Number where work is to be performed— No.____,. ___' _._ Street
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs
Feet of Drain Tile
Nature of Water Supply: City — Well.___
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
(Signed)
Date_
No. of Stories
Size Septic Tank Type of Tank Capacity Gals.
Dist. Feet of Tank or Drain Field from Well
• Size of Soakage Pit
• t
Plumbing Inspector. „to
The undersigned applicant for this building permit does hereby certify that he understands and accepts ix(
)ligations as an employer of 1
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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
perfonmed 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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No. _
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 No. Street
Registered Architect and /or Engineer
Employing Plumber's Name. _ ' No Street
Location and Legal Description Lot Block Subdivision__
Street and Number where work is to be performed— No.____,. ___' _._ Street
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs
Feet of Drain Tile
Nature of Water Supply: City — Well.___
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
(Signed)
Date_
No. of Stories
Size Septic Tank Type of Tank Capacity Gals.
Dist. Feet of Tank or Drain Field from Well
• Size of Soakage Pit
• t
Plumbing Inspector. „to
The undersigned applicant for this building permit does hereby certify that he understands and accepts ix(
)ligations as an employer of 1
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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
perfonmed 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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING El - , ,
DATE / 195
ELECTRICAL ❑ PERMIT 'N? 11475 coatr r s
PLUMBING P..-.--..- License No.
ROOFING ❑ Work to be performed under this Permit
Architect
Contractor
or Builder
Legal
Descripti
Address of
Building
Owner of
Building
Lot
Bl.
Subdi-
vision
r t Value of
` Project $
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 gc,iythe statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
.4-
CONTRACTOR OR BUILDER
INSPECTOR
BY
Signed • BY
In consideration of the issuance to me of this permit I agree to perform the work cov d hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specif' ati s submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, m • : nto want or employee.
Amt. of
Permit $
AUTHORITY
Permit No.
Size Septic Tank S�
Feet of Drain Tile
Nature of Water Supply: City —Well
Owner's Name and Address -
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 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.
No.
Street
Date / - 3 /
/'• C_ -_ Street
Registered Architect and /or Engineer _ _____________________________ A r
Street
Location and Legal Description Lot N 4 it/ ___ -- Block ` Subdivision/
Street and Number where work is to be performed —No ' `s �? / i
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No. of Stories
_Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed) tt_ E . a .' �
f Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he underskands and accepts his obligatio s 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.
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
44
(Signed) ..
{
Master Plumber.
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
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
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No.
Size Septic Tank S�
Feet of Drain Tile
Nature of Water Supply: City —Well
Owner's Name and Address -
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 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.
No.
Street
Date / - 3 /
/'• C_ -_ Street
Registered Architect and /or Engineer _ _____________________________ A r
Street
Location and Legal Description Lot N 4 it/ ___ -- Block ` Subdivision/
Street and Number where work is to be performed —No ' `s �? / i
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No. of Stories
_Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed) tt_ E . a .' �
f Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he underskands and accepts his obligatio s 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.
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
44
(Signed) ..
{
Master Plumber.
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
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.