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269 NE 100 St (12)1r MIAMI SHORES VILLAGE �.}j BUILDING DEPARTM T 305- 795 -2204 Building Inspection Reque Date& I Type Insp'n Permit No. Name mo■ Inspection Date Approved Correction Re-Insp'n Fee 52. Address CP ME 100S+ Company 0-3D- - l f Phone # p firc l� r,9,04 b MIAMI SHORES VILLAGE BUILDING DEPARTMENT `1) �,� 305- 795 -2204 ��� Building Inspection Request Date& Type Insp'n " t'1 I 4)10i Permit No. IC "5 . Name 1'0ULikoRA Address 9-o`--1 Ne 6031-- Company a ( )'1' A )0 Phone # 3C6 �OZ J) I Inspection Date 810 Approved Correction Re- Insp'n Fee ,9 494 A /66 (3 dl y MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Req Date 7/x/0 Type Insp' n F n n L Permit No. •• ?on `f- , 5c Name -- !^5 ; Address "6 4 ,A C io0.s r Company �f rt :' Phone # 30g 3a^ Inspection Date 8 /�d y Approved ❑ Correction k !J .0 d Re -Insp' n Fee ❑ ,X 4711e. Miami Shores Village Building Department 1711Eti 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �� Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. M C. 2004 '52 PERMIT APPLICATION FBC 2001 6 Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO City /711 -' State QualifierJ7 9: $ r Master Permit No. Permit Type (circle): Building Electrical Plumbing lMechanical Roofing Owner's Name (Fee Simple Titleholder) /70/1" AJ Owner's Address 4 dLJ ` 0 © S 7 City F7/ < S 11-- 93—State ...." Zip 3 $'( $ g— Tenant/Lessee Name Phone # 3 OS) ?� ©i Phone # Zip Zip 3 33/3 - Contractor's Company Name ,5��! Cc-t-of Phone # - j €5) Contractor's Address l d (� i ✓ � _ _32 d g Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit / D) 2 - Square Footage Of Work: Type of Work: ❑Additi n ❑Alteration ['New ' Repair/Replace ❑ Demolition Describe Work: e. L4C 3 t?- f4.-z 7 & pia T vZ7 .. * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * *** D Submittal Fee $ . r 5O .00 Permit Fee $ 6 a % CCF $ .Z CO/CC Notary $ Training/Education Fee $ 9 0 Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due . I 0 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a fee will be charged. Signature The fore day of oing instrument was ac by who is personally known to me or who NOTAR ' :LIB: Sign: Print: My Commission xpires: Chc 12/15/03 Ct CL- Owner or Agent APPLICATION APPROVED BY: (CL ln.-ti edged before e tivs/ f 9 .=-.?;) As identifi4 , I' 11 tiCavf h. g '`::;;: Commission #DD238886 Expires: Sep 09, 2007 ., OF f`�,.s Sign: Bonded Thru ^ '' Atla ti,. Building Cu., Inc. 0 9 4 '/ - 1 tiv j - */ *- :' cf s/ Print: NOTARY PUB The foregoing instrument was acknowledged before me this '/ day of �'.'� [ �- 20 64 / by who is personally known to me or who has produced My Commission Expires: S. (Certificate of Competency Holder) State Certificate or Registration No.0/4 L°CA/ 2 s' 7 Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** as identificQ,ti tmd Abiltitirkeetuckta Commission #DD238886 Expires: Sep 09, 2007 nded Thru • s u v g Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS . CENTRAL HEATING ,45 7 g ‘ ,. , / DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL)) 7.9.•J a/if l DRINKING FOUNTAIN SERVICE SIZE IN AM'S DUCT WORK FLOOR DRAIN SERVICE REPAIR/VETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (ROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS ' SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 if ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES - A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMAING POOL • OUTLETS COMMERCIAL WATER SERVICE SIGN MBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTIRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM.TO.BUILDING PERMIT APPLICATION (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 ELECTRICAL MECHANICAL Mechanical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: MC2004 -52 Printed: 4/29/2004 Applicant: CHRISTOPHER MACKLIN Owner: MACKLIN CHRISTOPHER JOB ADDRESS: 269 NE 100 ST Contractor SPRING AIR CONDITIONING Local Phone: 305 - 232 -1211 Parcel # 1132060134690 Permit Status: APPROVED Permit Expiration: 10/13/2004 Construction Value: $1,857.00 Work: REPLACE 3 TON AIR HANDLER EXACT CHANAGE OUT Signed: (INSPECTOR) Contractor's Address: 13501 SW 128 ST #113 Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & W1/2 LOT 21 BLK 34 LOT SIZE 75 X Fees: Description Amount FEE2004 -4314 Building Fee $100.00 FEE2004 -4315 CCF $1.20 FEE2004 -4316 Training and Education Fee $0.40 FEE2004 -4317 Technology Fee $2.50 Total Fees: $104.10 Total Fees: $194.10 Total Receipts: 0:00 sy, ( o May o i VAD Signed: (Contractor or Builder) BY: oq In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Date 7 Job Address 27cy 'v. 1/` 1 c/Osr Tax Folio 1 1 220 a ao t // Legal Description 1 ---tJ� (,L) ((2 2— I 0ck F1• G 1 C Lessee / Tenant 5 ,. T / Master Permit 4P .=. /0,g /DO 9 - Phone !1y . Address A V 2 "` e;')//-57- - S 5 Qualifier //��� SS# : - Phone C 3 State # Fta7 f7 Municipal #( -03 Competency # Ins .co /6 ,S4.0 Owner's Address Contracting Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cos (value 350- c/(/ 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. Signature bf owner and /or Condo President Date: Notary as to Owner and/or Condo President My Commission Expires: ** * * FEES: PERMIT APPROVED: Zonin PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Mechanical Ns mLL 1— , —74) Date: Notary as My Commiss C QAJ 1 - - ture of Contractor or er- Builder opuMe48 ffir -Bui 'r ely , ON I CC 324179 EXPIRES: October 18, 1997 Budd flan NA0 Puble Undmmtn 1'. Y\' Lder * RADON C.C.F. 1 NOTARY TOTAL DUE 0.1 Fire Other Building Electrical Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR _ RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK-, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS --TD,J / A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 1 HEATER -NEW INST. GENERATORS TRANSFORMERS J HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA -' RELAY TELEVISION OUTLETS GRAINFIELD, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM _ GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Date Job Address Square Ft. Signature Date: FEES: PERMIT APPROVED: K PERMIT APPLICATION FOR MIAMI SHORES VILLAGE • n <./' - /O /7`y /z.a & sZ. .qt L �✓� Legal Description Lo' 20 i f 1.0 7 _ 1 - M . s . Se Owner / Lessee / Tenant 7G` V ie Master Permit # b6c 1 51 Owner's Address 2 . 9 X/e /00 sT Phone '&6 S� 14 Contracting Co. ,0 /7 - C// / / e /VA-4`C Address 7 ZZ- 5. , e/ (4 . c.,Zc --/ /G //� Qualifier G� s� /' 4. /W�I' ss# 15;.!5 - 7- Co () 0 33 6 0 State # 40 Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address f owner and z or Condo President Notary as to Owne My Commission Exp rats.. u OFFICIAL caOTAHy SL Rr , ? :4 SCOTT W DAVIS +- * COMMISSION NUMBER ** * * * 'sk'' n • -* * * Nota My * * * Tax Folio 11 2 -0(40 I' -'(o `i C f`) Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION /'`y" SI /,V-,7710 - '/- w St /rte 57 s 7 / 2, o Se-&"- w�/. o 4ce.J -7-z•---„2 • el O v c7ce_aA - Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT Ai OUR 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 construct and zoning. Furthermore, I authori e the above -named contractor to do the work stated. -# L Sig r� % Date: it : pin * Fire Zonin_ Building Mechanical ~ ` C r Plumbing RADON C.C.F. 1 ` $a NOTARY ' e�lst> Builder r-Builder ** TOTAL DUE 15( Other Electrical Engineering PLANNING BOARD AGENDA OF MARCH 24 , 1994 Name of Owner /Applicant STEVE R. GROH Phone No. 666 5474 Address of Property, and /or Legal Description 269 N.E. 100 ST. Nature of Request Council Action Required APPROVAL OF ROOF TOP INSTALLATION OF A/C UNIT Present Zoning R 18.5 Area of Present Building Area with Proposed Addition Parking Spaces Provided Parking Spaces Required with Addition Setbacks as per Code Setbacks Provided Variances /Zoning Change NO NO CElligMniCitOnM r L O R 1 D ► ITEM NO. 5 A Date of Applicant Notification Planning Board Action Council Action Director of Building and Zoning 6.06' ala GL ti. '�s. -1r!• ._ ��. — •oaf./ 7 I�^ :T _ _ .::±)}Y.� R�lw`- �.�:a6K +.v!•feWer/+T_ .Y�rO Atf � o . ct I 0 IP 3 4 if F. ± 10 v 1 4\ 373 1 Al,,w (Nor a r - or . • ! � 'PAY zro� ZZ 3 s a CO i . .r (G) d M t N KTat- caet 1,1" wt-% r1tts4 r Lb F 1,uoQ o c i b t sl ctiot sd roRf iv GotilD 5 fvoK9 Ft.° .1 -1 t4 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Owner's Name and Address2 17 e /S /tfxtaax Registered Architect and /or Engineer Name and address of licensed contractor Chairman Member Member Council Approved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 2_.lu._ 9 /I/ State work to be done and urpose of building New Building Remodeling Addition To be constructed of Kind of foundation _ _ Estimated Total cost of improvements $ � Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor _ NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. PLANNING BOARD___ ..... Date a v e, , 19 � 2 • No �C Street_ ___41 /A® /t' o (by floors) 1 ?�•5 9-GA -'0d ,B Z2) and for no other purpose. Repairs No. of Stories Roof Covering Amount of Permit $__ ____1__,._�.� plan Cubage Size of Building Lot Date / > tc 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,,gerforned under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No 2/ ` O 7" Date___..F .6 - br . Disapproved __ _ -_ -. _______ __ .... (Signed) uilding Inspector Read, Sworn to and Subscribed before me. DATE Member Member Member Disapproved Notary Public, State of Florida My Commission Expires _____ Date making corrections or changes to this application after approval has been obtained from r . when such re- inspection is made necessary by improper notice for inspection or faulty • MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. ..l �.. [/ 7 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 T .Bb 6'A / Registered Architect and /or Engineer pw ,/�— Employing Electrician's Name._. t ..... �/..1�[ L ,L C C7 No ,( 0 // a treet 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 No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground on P Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ lecctric•l 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. STATE OF FLORIDA, COUNTY OF DADE. I 6s. (Signed) (Signed) ✓��'¢ Date <' / Street Master Electrician. 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, and 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. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.! HP MOTORS 1.S HP NEON TRANS. RADIO TOTAL CONTR. LIST Id o r1NYJi�N�il9� ,� /^ / {.may ,o, CHECK / %� �. i1= • MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. ..l �.. [/ 7 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 T .Bb 6'A / Registered Architect and /or Engineer pw ,/�— Employing Electrician's Name._. t ..... �/..1�[ L ,L C C7 No ,( 0 // a treet 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 No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground on P Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ lecctric•l 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. STATE OF FLORIDA, COUNTY OF DADE. I 6s. (Signed) (Signed) ✓��'¢ Date <' / Street Master Electrician. 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, and 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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date. __ lr. ,//�� Owner's Name and Address 1. _$ f ?.�!_ @ s_.__ �" iQ!! No �o / Street Registered Architect and /or Engineer _ Name and address of licensed contractor A.A. 6-e_ Location and legal description of lot to be built on: Lot Block Subdivision y� Street and Number where work is to be done A 4 __g ___1S!-- JQ ©' !'" ' y State work to be done and purpose of building (by floors) , ;� 7Z -- g_. .� __ - - re-, ,C_k -7- L— and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building__. Size of Building Lot 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 finder this permit, as are licensed by Miami Shores Village. - Remarks_. Disapproved ___ _ ( Signed) D (Signed). ,19n/ JS - 3.1 4 t' .A4.1:' Nfa STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 constructic t . he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No // Read, Date_U , Read, Sworn to and Subscribed before me. Notary Public, State of Florida ilding Inspector My Commission Expires PLANNING BOARD___ _____ ._._____________ DATE Chairman Member Member Member Member Member Council Approved _Date Disapproved 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. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Disapproved 7f f/ Dat (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Owner's Name and Address..... Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to . built on: Lot Block Subdivision Street and Number where work is to be done A State work to be done and urpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ cubage required plan Cubage Distance to next nearest building Size of Building Lot 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 subcontrac or wor to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signe ; �� Building Inspeptor No Date 19 9 Street STATE OF FLORIDA, COUNTY OF DADE. f ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No -"� Date 73' Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved 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.