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269 NE 100 St (16)S Date 7//5 7 -S PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER Ti RETAIN COPY) /010O s7- t .. 3 9 Job Address Legal Description Lc l zo¢` 4) %t .L/ ,/ lie .3� / Owner / Lessee / Tenant SC6 DL/& 54 .��v Owner's Address 6 A 3 MA4-4( S (Y' Phol Contracting Co. P 6�-S Address 1C'10/ C O ` d i'r 'P A i • A4 1 Qualifier State# Competency # Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL ' MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION (I) 7--00 y,Tyv • IQ(/AU G 1--me 4A-'J CC1ti111 . 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 zdning. Furthermore, I authorize the above -named contractor to do the work stated. ig ne an nd /or Co' President No Lary as to My Commission PERMIT FEE: � 4.fOO Ccf .;fO c3J: •ro Expires * * APPROVED: Zoning Mechanical MY COMMISSION EXP. NOV. 219,31 * Fire SS# Address Address Address - - Phone Estimated Cost rc81�t • C i Ni.� CC4 � 993 IDA $.4Y COMMISSION EXP. OV. 21,199 Sig re of Con a ctor • n'er- Builder Not Ty as o Co My Commission Expir * * * Tax Folio I / 3 z-O s Master Permit # � � Ins. Co. Other Electrical Engineering r-1.13',4)1 1 ittt• 7. 4.Pctli;.1/4. . t • "t . 1 , &47 Q`a 011 • II N 010 • .1 SKETCH OF SURVEY SCALE: 06c1 Ne lap 5+ /1/41(144 I s dzic P_S HQr A rAhr ab.) rir 40 _ *P7S •737 Flow 11/79 SECTION SCALE DWG. BY ©codvklec K. fu 6 (c 64 - 6 - z') 6T VS T1 U 10A- Li- CA) 16 .e d-1 0- L L -CP TANAV: I -,A-b G 6 PLre S12-F) _ I P Co-SS u _ L i 14). i (?s4 CA) — 2 11 F eOpleS GAS S S M Inc a 6 ( ^ ^ Ak(Amii pL. DATE SHEET J.O. A.F.E. X37 l.. �rl'�� � �l r .�.. r i �'� ill'•• '�, '. ... 11: �� li .r, 1 Date Job Address Vo 1 V (.= /OO J/ Tax Folio Legal Description Owner / Lessee / Tenant SCcy-t4 - ,001L4I^bc ✓-) Master Permit # 3 ? FC Owner's Address I LO !\J )0O 5+ree± Contracting Co. I icarl Shnre_S tPLB& Qualifie r r__t-f1 S MC'I O L4 i IIriSS# .](, Phone I— 4Lo State #(2F # Competency # c2 ct i ns.Co. C-c)►' 1'r")cl.� Architect /Engineer Address .•JJ Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION IS P,IiAcn.tp . Square Ft. Estimated Cost(value) l ®` 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 regulat''; construction and zoning. Furthermore, I authorize he ab6ve - d contractor to do the work Signa ure of owner and /or Condo President Date: 1 mil _ 1 otary a My Commis tc'•; pi EE38WA8 NOM Iq HMI ** * AFI * ARR• * § §§ * * * FEES: PERMIT RADON APPROVED: Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE erg �� m „' President Mechanical Address &15 D (\SV' Lo _ 44- p ture of ContIMP or •': Owner- Builder Date: 5//1186 otar :A tot •R° . acto or 3ZANilder My Commission 3 Commission n CC308759 4.� * Expires Aug. 18, 1997 ')» . Bonded by HAI * * * * m '4. p -422-1 * ** C.C.F. NOTARY Fire Other Phone <3U5j -454 - 89ari TOTAL DUE Electrical Engineering Permit No 13 1 4 5 Size Septic Tank_ .... Feet of Drain Tile-_. Nature of Water Supply: City—Well STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT -T 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 -___ a ll[ i_ T Registered Architect and /or Engineer__________ Employing Plumber's Name H A R .Ot_ D G . TA r i2. Z►d - , p yang ---- _ - - -- , Location and Legal Description Lot_ _-- - - - - -- -- -_ -___ Block Street and Number where work is to be performed —No Q (cC State work to be performed and purpose of building (By Floors) New Building _--- _-- _-- _-- --- .- ___ --- Remodeling Addition. _ _____Type of Tank_______ _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 0 t Amount of Permits (Signed) _ Street J O s re-t_ Repairs No. of Stories. _ Capacity Gals. 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 bus com- plier 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. (Signed)_ (-" Date_ 1171 Street_3 4 aria-E 7- _____ -._ Subdivision. _______.... .... __•---- -_ --_ -- My Commission Expires Notary Public, State of Florida 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. 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 TUBE URINALS CATCH BAGIN 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 SWING POOL CONTR. LIST 1 1 CHECK S. 0 0 S, 0 0 _ 10, 6 Permit No 13 1 4 5 Size Septic Tank_ .... Feet of Drain Tile-_. Nature of Water Supply: City—Well STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT -T 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 -___ a ll[ i_ T Registered Architect and /or Engineer__________ Employing Plumber's Name H A R .Ot_ D G . TA r i2. Z►d - , p yang ---- _ - - -- , Location and Legal Description Lot_ _-- - - - - -- -- -_ -___ Block Street and Number where work is to be performed —No Q (cC State work to be performed and purpose of building (By Floors) New Building _--- _-- _-- _-- --- .- ___ --- Remodeling Addition. _ _____Type of Tank_______ _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 0 t Amount of Permits (Signed) _ Street J O s re-t_ Repairs No. of Stories. _ Capacity Gals. 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 bus com- plier 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. (Signed)_ (-" Date_ 1171 Street_3 4 aria-E 7- _____ -._ Subdivision. _______.... .... __•---- -_ --_ -- My Commission Expires Notary Public, State of Florida 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. 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. ROLD G. JRHER, IBC. LAWN SPRINKLER SYSTEMS WELL DRILLING CONTRACTORS Miami Shores Village Building Dept. 10050 N. E. 2 Ave. Miami Shores, Fla. Dear Sir: Please issue permits as follows: Lawn sprinkler well --- ---- -- $5.00 Lawn sprinkler ------- -- ---- $5.00 HGJ /cm for: Marion D. Dodson 269 N. E. 100 St. 2141 S. W. 3rd Street Miami, Florida 33135 May 3, 1971 Attention: Mr. Wm. Bradford Enclosed herewith is Dade County License and our check in the amount of $10.00. The Certificates of Insurance are being mailed to you by our insurance agent. Yours , - ry truly, HARO JAFFER. INC. old G. J President • P. O. Box 518 • Phone 642 -6761 Permit No Amount of Permit $_--4 ;2 1 /-1 Owner's Name and Address The undersigned applicant for this building permit does hereby _**se under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereoi and will require similar compliance performed under this permit; ana will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT X 2 / 3 -4 '7 Date 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, iC N Street__• Registered Architect and /or Engineer Employing Plumber's Name No Location and Legal Description Lot______ ?_..`_ Block ? $e. Subdivision Street and Number where work is to be performed— No.___,.,., t � ;' Street__l_:______:�� i1__ State work to be performed and purpose of building (By Floors) New Building — Remodeling Addition Repairs ____ No. of Stories Size Septic Tank_____________ ______, _ Type obi Tank . Capacity Gals _________ ____.______� Feet of Drain Tile______ ,/___t1�: _� ______ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City' --VeH- Size of Soakage Pit STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized (Signed) • Street f Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has corn- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are f -`�. (Signed) ----- ------- - - - - -- -- �- / , ; , / Master Plumber 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 therein by him stated are true. Notary Public. State of Florida to administer oaths and take ' acknowledgments, personally sign the same, and that all facts NOTE: A re- inspection fee of $1.00 will be made li en such re- inspection is made necessary by imptioper notice for inspection, or faulty materials and /or workmanship. - CLOSETS BATH TUBS SHOWERS LAVA- TOR IFS SINKS SLOP SINKS LAUNDRY Tuns 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 SWIM'G POOL CONTR. LIST CHECK Permit No Amount of Permit $_--4 ;2 1 /-1 Owner's Name and Address The undersigned applicant for this building permit does hereby _**se under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereoi and will require similar compliance performed under this permit; ana will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT X 2 / 3 -4 '7 Date 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, iC N Street__• Registered Architect and /or Engineer Employing Plumber's Name No Location and Legal Description Lot______ ?_..`_ Block ? $e. Subdivision Street and Number where work is to be performed— No.___,.,., t � ;' Street__l_:______:�� i1__ State work to be performed and purpose of building (By Floors) New Building — Remodeling Addition Repairs ____ No. of Stories Size Septic Tank_____________ ______, _ Type obi Tank . Capacity Gals _________ ____.______� Feet of Drain Tile______ ,/___t1�: _� ______ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City' --VeH- Size of Soakage Pit STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized (Signed) • Street f Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has corn- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are f -`�. (Signed) ----- ------- - - - - -- -- �- / , ; , / Master Plumber 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 therein by him stated are true. Notary Public. State of Florida to administer oaths and take ' acknowledgments, personally sign the same, and that all facts NOTE: A re- inspection fee of $1.00 will be made li en such re- inspection is made necessary by imptioper notice for inspection, or faulty materials and /or workmanship. - Permit No Owner's Name and Address 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 wor Registered Architect and /or Engineer Employing Plumber's Name _ No Street Subdivision _: .... ___.__ Street and Number where work is to be performed— No.___ State work to be performed and purpose of building (By Floors) New Building — _ Remodeling Addition Repairs No. of Stories Location and Legal Description Lot__ ,1 Block Size Septic Tank Feet of Drain Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Vieth. Size of Soakage Pit Amount of Permit $_ 4- The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit: and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly ss. 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT I' No. – Type of Tank . Capacity Gals ' Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) (Signed) ____; Date y e � Street.__ /L!� 3- Master Plumber. s authorized to administer oaths and take acknowledgments, personally 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 SWIM'G POOL CONTR. LIST CHECK Permit No Owner's Name and Address 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 wor Registered Architect and /or Engineer Employing Plumber's Name _ No Street Subdivision _: .... ___.__ Street and Number where work is to be performed— No.___ State work to be performed and purpose of building (By Floors) New Building — _ Remodeling Addition Repairs No. of Stories Location and Legal Description Lot__ ,1 Block Size Septic Tank Feet of Drain Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Vieth. Size of Soakage Pit Amount of Permit $_ 4- The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit: and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly ss. 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT I' No. – Type of Tank . Capacity Gals ' Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) (Signed) ____; Date y e � Street.__ /L!� 3- Master Plumber. s authorized to administer oaths and take acknowledgments, personally 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.