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278 NE 101 St (7)
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 4- t/- o, Job Address i. 7S E. /0/ Tax Folio 11 — J U ,ip - p 1 - CO CO Legal Description ef/Lessee / Tenant lAc"' " 4f t N STo Owner's Address 7 e 0(.217_ /P, $f-G27, C o n t r a c t i n g Co. 6 a ( S R c C) 63 Qualifier L ' 1.ne l s. lTa��ceJ State # A ��Z� Municipal # Architect/Engineer Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRIPTION 1 Square Ft. Estimated Cost (value) 2 D • 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. 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. vut...u�n5� 6- l Signature of o r and/or Condo President Date mmission Expires: gt as to Owner and/or Con % • 'resident o,•tar ° .forge M. Gutierrez '4 ° Notary Public, State of Florida > ; f Commission No. CC 660628 - l eoFftt % My Commission Exp. 08/11/2001 4 1- 800.3- NOTARY - 13. Notary Service & Bonding Co. FEES: PERMIT ° RADON C.C.F. • O i) NOTARY 1— BOND t 6 - -0I Date Historically Designated: Yes No Address 5) -/ 5 O Competency # Address Signa Notary My Co Master Permit # y q / q g Phone 303":701- fPc9oo exa)(3-0 ;Jetta, Ins. Co. ROOFING PAVING FENCE SIGN 3 r � hs TOTAL DUE 71 APPROVED: Zoning Building Electrical f '6 2 4 o Mechanical (C' . 6 r / Plumbing Engineering M H TL8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE ET LIGHT CUTLETS CENTRAL HEATING h'WASHER RECEPTACLES A/C (WIN)) POSAL SERVICE TEMPORARY A/C (CENTRAL) NKING FOUNTAIN• SERVICE SIZE IN AMPS DUCT WORK OR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION ASE TRAP APPLIANCE CURETS PROCESS AND PRESS PIPING ERCEPTOR RANGE TOP UNDERGROUND TANKS ATORY OVEN ABOVE GROUND TANKS NDRY TRAY WATER HEATER U.F. PRESSURE VESSELS TEES WASHER MOTORS 0- 1 HP STEAM BOILERS nER MOTORS OVER 1- 3 FP HOT WATER BOILERS K, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION K, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES K, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS PORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS NAL MOTORS OVER 25-100 HP COOLING TOWERS ER CLOSET MOTORS OVER 100 HP VIOLATION IRECT WASTES A/c WINDOW REINSPECTION ER SUPPLY TO: AIR CONDITIONERS / ' t E Pt, Itc. a e/1/P /C UNIT STRIP HEATER IRE SPRINKLER GENERATORS TRANSFORMERS EATER -NEW INST. GENERATORS TRANSFORMERS EATER - REPLACE GENERATORS TRANSFORMERS AWN SPRINKLER -WELL SPECIAL PURPOSE N I Mf I NG POOL OUTLETS COM4, RC I AL ATER SERVICE SIGN TUBES :R CONNECTIONS SIGN TRANSFORMERS .ITY -SEWER SIGN TIME CLOCK .ITY -WATER FIXTLRES .IC TANK ANTENNA ■Y TELEVISION CUTLETS NFIELO, 4' TILE/RES. VIOLATION ' & ABANDON SEPTIC TANK REINSPECTION T AGE PIT CU. FT. H BASIN `1ARGE WELL :STIC WELL - ~- DRAIN ' INLET R WATER HEATER STANDPIPE PIPING SPRINKLER SYSTEM RANGE R SET (GAS) PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION N APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. BTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or erne plans and specifications herewith submitted for the build • inc 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 bc kept at building during progress of the work. Owner's Manx and Address Date. g '. ��....... , I9.J�► v ! — No 72 . Stree s /0/ �f r . t ... - - -- -- ems- f J, Registered Architect and /or Engineer _,.,, ,..••• .... ., "MS .n.,..• .. .... G ,111 6 Name and address of licensed contractor.R.e L.d. 4i.: LeQ ..._.. Location and legal description of lot to bc built on: Lot -- `F Block Subdivision Street and Number where work is to be done... 75_ .. State work to be done and purpose of building (by floors) .. C2NE ti; _.... '7o ti 2C1:2'. %y.... 7 ..73.. w✓ 7 3 6 P and for no other purpose. 5.eeg 9 .... 1:rQ/ '9 T..r ......_ Ncw Building Remodeling Addition Repair, No. of Stories To be constructed of Kind of foundation R� Estimate, Total cost of improvements S..3. 0 — Amount of Permit S. �r. ..f.1 _ 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 s It public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcon• s, on work to bf per yned under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, 1 . COUNTY OF DADE. J ss. Before me, the undersigned authority, a notary public, duly authorizcd to administer oaths and take acknowledgments, personally ap- peared -- -• — 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 lime, and -that all facts therein by him stated are true.. Permit No.._.�& T' r Date Nl � Re • . • rn t • a d Subscribed Disapproved (Signed) Chairman \Icrr,ber Member .. .. _ ...-•- ......- •--- ._....- ....... Member otary Public, Stat4 q(c1 t' da My Comm (ssiori. _..._.._._ �•, :cl vd-'''a)�/\TE ,,„,.3oc ri., PLANNING BOARD taut 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 hero obtained from the PI, nnir,g Board. A rc•in.peutiun fee of 51.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials anti /or workmanship. be to me well known, Permit No MOgo© MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J p J v' ys/ 9 T Date /�Z Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI o ► structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :it 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 Divisio, 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 Ceta .4 . LzAvee No a..! v me Street 1 4 Registered Architect and /or Engineer .�t \ Employing Electrician's Name.....A.Q.1/AIII C.Ls.O ELECnt I'G,..IVC....No..�.4.4..f / S.t.&..Street...tQ�.J / • 47)e vs/7\ 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) 4/1.t .iE c 6A"T 4 L / >S'.,Y.s " New Building Remodeling Addition Repairs No. of Stories Service Overhead Underground Site Feeders Conduit Main Sw Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ V . ( � 0 (Signed).. Electrical 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 OP FLORIDA, COUNTY OF DADE. I U. (Signed)..���.. 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 0 LIGHT OUTLETS PLUG RECE•P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP H TOTAL CONTR. IST LIFT il 2A2 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIFT 3/0 • 3-1 CHECK Permit No MOgo© MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J p J v' ys/ 9 T Date /�Z Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI o ► structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :it 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 Divisio, 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 Ceta .4 . LzAvee No a..! v me Street 1 4 Registered Architect and /or Engineer .�t \ Employing Electrician's Name.....A.Q.1/AIII C.Ls.O ELECnt I'G,..IVC....No..�.4.4..f / S.t.&..Street...tQ�.J / • 47)e vs/7\ 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) 4/1.t .iE c 6A"T 4 L / >S'.,Y.s " New Building Remodeling Addition Repairs No. of Stories Service Overhead Underground Site Feeders Conduit Main Sw Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ V . ( � 0 (Signed).. Electrical 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 OP FLORIDA, COUNTY OF DADE. I U. (Signed)..���.. 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.