361 NE 101 St (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 6- r Z / - 93 Address J /v f /V , E. 7O / s7 A°EJT Tax Folio
Legal Description /� Historically Designated: Yes No
Owner/Lessee / Tenant O�1/ 9 77/1L 4 E5/ R LI k y DielkoOx Master Permit # 3 7 /'�
Owner's Address .-3 6 / h/. E JO / 3 7 E Phone 7c2 9 ( 7
Contracting Co. ,e, E. . , ENT- Aofig /sE 5 Address 73Q A! w, /38 Sri(°E'CT
Qualifier � ' seGU/ n/ f7- PE rSe, SE
State # C oo oo / 9 G Municipal # Competency # Ins. Co. 4 /?ATE TT 7/v5_
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / /'57, G /¢T/ o iY OA 4 TO 4 e E'NTA", 1 ���
L / T t( /D /' /-0 //ex /
SS# //. Phone !v g/-0.57/
Square Ft Estimated Cost (value) Qd
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 of owner and/or Condo President Date Signature of Contractor or Owner- Builder Date
d'o/iLd/u4) t(L,Q,e
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder
My Commission Expires: My Commission Expires:
... +...ter .., +« *� OFFICIAL SEAL
• 39:11 t SANDRA KIIHNL COOK
It My Commission Expires
4 • �: : A:):11 21, 1996
• :r.' Comm. No. CC 188809
FEES: PERMIT / ''4"O RADON C.C.F. . STS NOTARY TOTAL DUE
Date
391)
APPROVED:
Building Electric / ✓G�l' 95
Zoning g rte"`
Mechanical Plumbing Engineering
istes
Dwoy
t
ITEM
BATH 1L8
UNIT
•
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WINO)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN MPS
DUCT WORK
FLOOR CHAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUIC TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNCRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTCRS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATCRS
TEMPORARY WATER CLOSET
MOTCRS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
_h
32),_
A/C UNIT
,
STRIP HEATER
/
P-
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
-
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
_
_ SPECIAL PURPOSE
SWIIIiING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TIKES
SEWER CONNECTIONS
SIGN TRANSFORMERS
_
UTILITY -SEWER
SIGN TIME CLOCK
-
UT I L I TY -WATER
F I XTI,RES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION CUTLETS
ORAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
1
SOAKAGE PIT CU. FT.
CATCH BASIN
3?
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
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
Date ?' 2 " 2 - "
ELECTRICAL ❑
PLUMBING ❑ PERMIT N? 10382
ROOFING ❑
Thr
.1 1 :.
Owner of
Building
Architect
Contractor -"
or Builder
be - 4 t C # A C t t'. •',
Legal Lot
Description 11 B1
/ ` t
Address of 3l� t N J r 0 f _3 ci
Buildig
Work to be performed under this Permit
Contractor's 1 ? f
License No.
Subdi-
vision
Sq Ft.
Value of 11 Amount of
Project $ 11 Permit $
9�
19
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plan or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants employees. /- /
Signed • tr), ( INSPECTOR BY
In consideration of the issuance to me of this permit I agr e,to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawi • _ ";statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work d by either, myself, my aget}t, servant or employee.
BY AUTHORITY
CONTRACTOR or BUILDER
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No /• 3.(p - z-
ffd X
No 3
Date
8 -- o- 6 sa
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.
Street ire
/ s
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's . -r6 Q._D Street...
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.
Underground
Type of Installation — Conduit Tubing B.X.L
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed).
Amps Main Fuses Amps
Metal Moulding
1 Elec I szector.
ccepts his � igations as an employer of
of Florid. Permanent Supplement, and
sub-con ractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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
R ANGE
CONN.
WATER
HEATER
W. H EAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
M OTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CL,sr
LIST
i SO
'fr1
M Off)
�` �,A f:
E . TeV
rz
0 n U r-
/J'
`
3 oz
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No /• 3.(p - z-
ffd X
No 3
Date
8 -- o- 6 sa
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.
Street ire
/ s
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's . -r6 Q._D Street...
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.
Underground
Type of Installation — Conduit Tubing B.X.L
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed).
Amps Main Fuses Amps
Metal Moulding
1 Elec I szector.
ccepts his � igations as an employer of
of Florid. Permanent Supplement, and
sub-con ractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? . 1052
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed• By , •
INSPECTOR
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 responsibility for all work done by either myself, my agent, servant or employee.
} I
Subdi-
vision
Value of
Project
!1.
BY
i r
DATE 194
Contractor's -
License No.
Amt. of
Permit
AUTHORITY
FLOORS
FIXTURE ONLY
NUMBER OF
Total
Outlets
SIZE OF
Size Service
Conduit
No.
Circuits
Lights
Ceiling
Brackets
Mains
Subs
Branches
asement—
irst
:cond
hird
ourth
��
'
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE 'INFORMATION. ALL SPACES MUST BE FILLED OR APPLICA-
TION L BE RETURNED
Lot Number Block Number Subdivision 1 t ' :. `•`
Street and N tuber 3 G / ‘11 C f fl r „C/f ' Side
Aerilk_Crtrg ,,,, /
Owner
Occupied as a9(
Building —New or Old (underline which).
H. P. of each motor
Kind of Installation Open or Concealed Knob, RX., BX., Mldg. Conduit
F
S
By
Lights
REMARK
Contractor
Progress
Will Inspect agaiiii
Rough Wirin
Ceiling
DAT ak ` , 1 /.7
Electrical Department. of the ity of Miami
Desiring your Certificate of Approval, application is hereby made
for an inspection of the electric installation in the premises stated be-
low, for which undersigned agrees to correct any infractions of the
National Electrical Code and the City Ordinance pointed out by Inspector.
Brackets
FINAL //-I No
Corrected
Temporary .Days
Date Issued
1s
Receptacles
APPLICATION
Volts
Switches
Occupant
Work— Additional, New, Altersltion or La
Total Amps Phase
Stoves I Water Heaters
Inspection Wanted fir► '
z 7r
ti Address 12 1 /" C, ..�"
SPACE BELOW FOR INSPECTOR'S USE ONLY
Received by Inspector ty r2 Inspected
Remarks /
Fee remitted �J
N o.
Signs
Other Apparatus
Inspector