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318 NE 101 St (4)M1151`Ez 1 *1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE. ' 0A a R l o Date ?' 9-99 Job Address 3 ' )\)L._ )61 Legal Description LL__ �1wner Lessee / Tenant � 7 Master Permit # ;7 im Owne Address 3 101 4 51 " Phone O Contracting Co CY ) 1-1 TS1i.i 1 L D Address W) ' (��i ,Noy. HOLZrODO, Qualifier 41) i DON It LikNOYTWO SS# Phone(16i) � _ D5 State JAOS` CIR Municipal # Competency # Ins.Co. 4'VIJ)ONtL 1 45_ Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING � y ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION (�.�CL S�11OW ak PAID ` � ( - y)011 - Square Ft. Estimated Cost(value) 1 366- 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 state Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: FEES: PERMIT RADON C.C.F. APPROVED: Fire Other Zoning Buildin Mechanical Plumbin Tax Folio Signature of Contractor or OwneflBuilder Notary as t My Commissi NOTARY 1 5! • :,,.1 AgtetT i a T 4 -Odll • er i � COMMISSION NUMOE Q CC255237 F MY COMMISSION EXP. P�N , * . J A ;. * ** TOTAL DUE .0' ° `) Electrical 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 MPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/IETER 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 01. f N I 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 Re Sri / MOTORS OVER 100 HP 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 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 DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA CRAIN 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 BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL 9'f I 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 _ e T / - _. -1__ f '' G No. Registered Architect and /or Engineer Employing Plumber's Name -_L Location and Legal Description Lot 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. Permit No Size Septic Tank_ . __.--- - - - - - - -� -- _____Type of Tank,_ Feet of Drain Ti1e._._/.2- Nature of Water Supply: City - Well. __,_---- .- . -__ -- - - -_ —.. -Size of Soakage Pit Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Dist. Feet of Tank or Drain Field from Well. Bloch (Signed) LA-2 Date.. 3..: Capacity Cals. Street._ -3C P.._:. , ti o l s Street Repair No. of Stories Plunt , ... C i g Inspecto,, employer of labor The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Sul ement, and Isar 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 perinit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, I µ COUNTY OF DADE. 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 neoasary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH Tuef HOW SHOWERS LAVA• Tomlin SINKS SLOP SINKS LAUNDRY Tuse URINALS CATCH DAAIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURE[ CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DRIP WELL SPRKLR. SYSTEM SWING POOL Co. NTR LIST CHECK 9'f I 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 _ e T / - _. -1__ f '' G No. Registered Architect and /or Engineer Employing Plumber's Name -_L Location and Legal Description Lot 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. Permit No Size Septic Tank_ . __.--- - - - - - - -� -- _____Type of Tank,_ Feet of Drain Ti1e._._/.2- Nature of Water Supply: City - Well. __,_---- .- . -__ -- - - -_ —.. -Size of Soakage Pit Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Dist. Feet of Tank or Drain Field from Well. Bloch (Signed) LA-2 Date.. 3..: Capacity Cals. Street._ -3C P.._:. , ti o l s Street Repair No. of Stories Plunt , ... C i g Inspecto,, employer of labor The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Sul ement, and Isar 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 perinit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, I µ COUNTY OF DADE. 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 neoasary by improper notice for inspection, or faulty materials and /or workmanship. Permit No. Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 3 (F3 Size Septic Tank Type of Tank Feet of Drain AN -------- Dist. Feet of Tank or Drain Field from Well--_-__ (Signed) — Date_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi(ted for e 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 $� �1_'�______ No 81 _ Registered Architect and /or Engineer ____ —____ ___ — /' Employing Plumber's Name _ ,f�_ _r_,� !!_[_ No._____ Street_�s • • d / Location and Legal Description Lot____ — JL 1C_____Block -- 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 Street Subdivision Capac' y Gals .Size of Soakage Pit ____________ ______ ______________ The undersigned applicant for this building permit does hereby certify that heLt derstands and accepts his obligations as an(gytfployer 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 under signed 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. Notary Public. State of Florida No. of Stories Plum Inspector. 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. Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 3 (F3 Size Septic Tank Type of Tank Feet of Drain AN -------- Dist. Feet of Tank or Drain Field from Well--_-__ (Signed) — Date_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi(ted for e 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 $� �1_'�______ No 81 _ Registered Architect and /or Engineer ____ —____ ___ — /' Employing Plumber's Name _ ,f�_ _r_,� !!_[_ No._____ Street_�s • • d / Location and Legal Description Lot____ — JL 1C_____Block -- 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 Street Subdivision Capac' y Gals .Size of Soakage Pit ____________ ______ ______________ The undersigned applicant for this building permit does hereby certify that heLt derstands and accepts his obligations as an(gytfployer 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 under signed 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. Notary Public. State of Florida No. of Stories Plum Inspector. 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. 3 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 ___ (, — ___,/'!_ft��!!_.__________ No. Registered Architect and /or Engineer Employing Plumber's Name __ _ _ _ T 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_ Septic Tank_-___ — _— .— ______ Type of Tank Feet of Drain Tile_____ Q___- __- __-- -__ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $_ APPLICATION FOR PLUMBING PERMIT _too ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 3ir 2Lt treet../ o/ No.__ Street----- aC__i!�c - _�r ✓� Size of Soakage Pit (Signed) _________ Date_ apac' y Gals._ O _�_____�� Notary Public. State of Florida (Signed) Plumbing Inspector. -- The undersigned applicant for this building permit does hereby certify that heLutiderstands and accepts his obligations as an gplployer 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as ate licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 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 TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N5 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. 3 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 ___ (, — ___,/'!_ft��!!_.__________ No. Registered Architect and /or Engineer Employing Plumber's Name __ _ _ _ T 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_ Septic Tank_-___ — _— .— ______ Type of Tank Feet of Drain Tile_____ Q___- __- __-- -__ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $_ APPLICATION FOR PLUMBING PERMIT _too ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 3ir 2Lt treet../ o/ No.__ Street----- aC__i!�c - _�r ✓� Size of Soakage Pit (Signed) _________ Date_ apac' y Gals._ O _�_____�� Notary Public. State of Florida (Signed) Plumbing Inspector. -- The undersigned applicant for this building permit does hereby certify that heLutiderstands and accepts his obligations as an gplployer 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as ate licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 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. OWNER LOT BLOCK SUBDIVISION Date Issued to ddliami cfhores9 llage F L O A ID A to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_i_story building at ' PLUMBING PERMIT N9 743 Fixtures Fixtures 1' Sewer / $ Septic Tank $ Total $ Village Plumbing Inspector Received Payment by 1� ` ` OWNER LOT BLOCK SUBDIVISION .i'/1// 4 LA f11/ir,4/ 9 r LC /r). 2/2_ � :t ;', At _A:r , e 7/ / ssued to -t 1 iarni �hores' llage F L O A 9 D A PLUMBING PERMIT N9 743 4 !/t. t_ . to install the following described plumbing, in accordance wf h the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. f ^' i 7 For a _.story _ / ' ° ,, . j ,, 44 building at �Jr' / 9 % (:7 / / ,,,,r r Fixtures .ts o pt 1./ CI e m e z !,: ';4, /, -, 4 -0 �� c. f . v ,:,/,:, / - . ,i, , / fr f r Fixtures p $ Sewer tic Tank Total $ $ Village Plumbing Inspector (( /* , Received Payment by s' � � 4r. JXC% e t-