258 NE 100 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
la �.�, loa n � to Date I igq Job Address2 g k \o ■ � \ a--Ig , o , Tax Folio
Legal Description 5 c"4 '°Sk 0-\� o3 C 'Historically Designated: Yes �'''"-- No kL
,mask( ,3" n Mac - ,0 . �o Ntf1 �c : cr 4 ::1 PC9
Owner/Lessee / Tenant tc.1..lo�e.24' o . 0 c),,.% s co.' d EN t■s 9 • a' S Master Permit # 415 Di
Owner's Address 25S tA • , too k - M o..,..1.% o) ' "FL Phone a - JJJ 554 2 6 SI
Contracting Co. CD 4.1 'R Address waQ o-s L.l' v.9
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company Address
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL RO
WORK DESCRIPTION
Square Ft.
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.
1011'1160 -�
Date Signature of Contractor or Owner- Builder Date
i� �✓
Signatur j.f owner an r Condo President
/Y7SC2 12-S-3 6 46
N. aryasto
My Commission
FEES: PERMIT . 0 RADON
APPROVED:
Zoning
Mechanical
t)-gta 3-20
wn
a' .r � $ �a ;C9
-. l ' ' � :. SEAL
. ires: GLADYS J V1I.LAR
NOTARY PLIBLICSTATE OF IFIORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR.12002
Buildin g M `6 l 41
Estimated Cost (value)
ia _` y_yj
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
goo
C.C.F. I ' 0212 NOTARY ' - BOND 3a
/ za
TOTAL DUE_3 �
Electrical
Plumbing Engineering
n
c,Lnw
Q2 Si
Fnd.—/
N &N)
0.2'c
Lot 6
C.LFence—A
Fnd.
1. Pipe
(N &N)
0.3'
SKETCH OF BOUNDARY SURVEY
SCALE: 1" = 20'
100th STREET.
....................
:19.5' Asphalt Pavement::
TOTAL
Fnd.
(N &N)
1.0'cl
Lot
2
Blk
Corn
203.0'
0
2
Fnd.
N e
&N)
4
BEARINGS SHOWN HEREON (W ANY) ARE REFERED TO AN ASSUMED MERIDIAN OF FOR THE CENTERL ENE OF
k) __ o
- D iJ �► .
C.LFence
z r.
X
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /JobAd a g rte— 1O0 Sr Tax Folio
Legal Description Historically Designated: Yes No
3 Owner/Lessee / Tenant Kevin G . Sexton Master Permit # 3 7�
Owner's Address 258 N.E. 100 Street, Miami Shoresphone 758 -1586
Contracting Co. Adco Patch, Inc. Add 3091 N.W. 129 St., Opa Locka, FL
Qualifier Eddie J. Barnes Phone 681 -2196
State # Municipal # Competency # E - 140 Ins. Co. Travelers Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. 56 Estimated Cost (value) $511.00
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 construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date gnature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires:
My Commission Expires:
FEES: PERMIT
Remove old asphalt and haul off
RADON C.C.F. /•
1/24/96
NOTARY TOTAL DUE f
APPROVED: -444 ix C
Zoning Building ` Tv. Electrical
1
Mechanical Plumbing Engineering
Date
Description
O w n e r / L e s x e Teo ant
Owner's Address
Contracting co.
Qualifier ci
State #
Avollitect/Enginco
Bonding C:otupany -
Mortgagor
Permit Type (circl.
WORK DESCRIP1'
S ware FL .
WARNING T()
RESULT 1N YOUR
CONSULT W1TH
Application is here
cer tif y that all work
are required
OWNER'S AEFIDA
lows regulating coust.
' ? 1 ‘
Sis olowrier •
FT:PS: PERMIT
APPROVE!):
Zoning_
Mechatucal___
• . . -•
Notary e.9 to Owner a )d/or Condo President Date
My Corrm Ex tes:
CROOKED CREEK INC.
I'.?,RMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job .I3dress Tax Folio
Hisiorcafly Ocignated No
<evin G. Sexton . Master Permit it
258 N.E. 100 Street, Miami Shores ph. 758-1586
Ac Patch, Inc. Add 3091 N.W. 129 St., Opa Locka, Fl.
e . Barnes Phone 681
Ins, Co. T r 8 velers Ins. Co.
E
Address
Addreas
Address :
rie): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOlilts1G PAVING FENCE SIGN
ON Removeoldasphaltand haul off
56 EstimWdCosqwdue) $511.00
'NEI.: YOU MUS1 RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
4Y . iG 'MICE FOR IMPROW,MENTS TO YOUR PROPERTY (IF YOU MEND TO OBTAIN FINANCING,
01.11 LENDER U1 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
trio :0 to olltain a perrl to do work and installation as indicated above, and OR the attached addendum. (if a)plicable).
vill performed to meet the standards of all laws regulating construction in this jurisdiction. 1 understand that separate
r El :F.CTRICAL, PLUMB1NO, SIGNS, POOLS, ROOTING and MECIIANICAL WORK.
IT: certify that all the foregoing information is accurate and that all work will he tine in compliance with all applicable
ctio and zoning. :Furthermore, I authorize the above-named contractor to do the work stated.
nd,'ot Condo President Date Ygnature of C tractor or ON
otary as to C for or Own
My Co • •
„ Pu OFFICIAL NOTARY SEAL
0 BEVERLY J MURPHY
cr o
itc * COMMISSION NUMBER
- c C373716
MY COMMISSION EXP.
OF Fk.° MAY 19 1998
TOTAL DUE
R.A.11)0N C.0
Electrical
3670801 P.01
1/24/96
Date
/—ZV1C
Date
• '1';
January 2, 1996
PONSOil non
Dade County Public Works
Permits Section
Suite 1430
Miami, FL
AI, .Eddie J. Barnes, authorize the following persons, Michael
A. Mantell and Calvin S. Ellis to apply for and receive
permits for ADCO PATCH, INC.
Eddie J. Barnes
President
Michael A. Mantell
Vice President
Calvin S. Ellis
Supervisor
everly Murphy
Notar Public
,p,YY P OFFICIAL NOTARY SEAL
0 G BEVERLY 4 MURPHY
R A ' e U y COMMISSION NUMBER
1s0, Q CC373718
� . + 4• MY COMMISSION EXP.
;, ,..... .F � MAY J 9
gz
•
ADCO PATCH, INC. 3091 N.W. 129th STREET, P.O. BOX 262, OPA LOCKA FLORIDA 33054
PHONE: DADE (305) 881 -2196 FAX (305) 881.3194 BROWARO (305) 525.8877