824 NE 100 St (11)• Date
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Legal Description f /�IY/�ff0gi5 ) C 6 /477 W4 z- Historically Designated: Yes
• Owner /Lessee / Tenant L L /��1 6%!� [ � ��� Master Permit #
227 /1/_ /
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Contracting Co. ' "./= ✓� >��'� , =0 �'i
Qualifier
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Owner's Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION %��,iz ��4 7/ /PA/9 P/7�C 7 7/i/(1- , d/ — T ) 7 Z/, ',E e P YO F/.
Square Ft. / 0 d
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address �!/ x//E Tax Folio 17 32-0
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.
7/tz
Signature of owner and/or Condo resident Date
N otary as to Owner and/or Condo President ate
My Commission_Expires:-- �1 -a_`9 7
gPt P110 BFFL=d, C,nTA V MAIL
FEES: PERMI
RADON
C.C.F.
SS#
Address
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
Phone 759-7 rO /
Pee/or/Vt- - O57
JNr�� f , / R- Iftiiry
Estimated Cost (value) ailrb7. 1(j
Signature of Contractor or Owner- Builder Date
Phone
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
Electrical
Date Q®. ?9 >4
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Permit No. AS a`Clif
building during progress of work.
r
Size Septic Tank__ .
Feet of Drain Tile __
Amount of Permit $
Owner's Name and Address.
Registered Architect and /or Engineer
Employing Plumber's Name s ' '' f -..�- _ _.____� No. -. Street__
Location and Legal Descriptio Lot.__ Bl _
Street and Number where work is to be performed —No ..41i CtiL-
Street_ _
State work to be performed and purpose of building (By Floors)
New Building -- Remodeling ._ Addition Repairs.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__ Capacity Gals.
Dist. Feet of Tank or Drain Field from We1L
No Street
Nature of Water Supply: City —Well -_ Size of Soakage Pit
(Signed)
Subdivision
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au employer 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally :Ippeare
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 tae•
therein by him stated are true.
y Commission Expires Notary Public, State of Florida
NOTE: re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul
materials a or workmanship.
CLOSETS
BATH
TUBS
SHOWERO
LAVA..
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUeB
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT N5
TOTAL
FIXTURCI
CONTR.
LIST
—
- ..—
CHrCK
SEPTIC
TANK
SEWER DRAIN
CONN. FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIOT
CHECK
_.....0°
i
_
_
Date Q®. ?9 >4
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Permit No. AS a`Clif
building during progress of work.
r
Size Septic Tank__ .
Feet of Drain Tile __
Amount of Permit $
Owner's Name and Address.
Registered Architect and /or Engineer
Employing Plumber's Name s ' '' f -..�- _ _.____� No. -. Street__
Location and Legal Descriptio Lot.__ Bl _
Street and Number where work is to be performed —No ..41i CtiL-
Street_ _
State work to be performed and purpose of building (By Floors)
New Building -- Remodeling ._ Addition Repairs.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__ Capacity Gals.
Dist. Feet of Tank or Drain Field from We1L
No Street
Nature of Water Supply: City —Well -_ Size of Soakage Pit
(Signed)
Subdivision
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au employer 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally :Ippeare
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 tae•
therein by him stated are true.
y Commission Expires Notary Public, State of Florida
NOTE: re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul
materials a or workmanship.
Permit No. ___l 12
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date June _._4 2953
i
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
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 Divisior
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 Uaj.nes Cont. Co No Street
Registered Architect and /or Engineer
Employing Plumber's Name.. J. M.___ louncil No. Street
Location and Legal Description Lot_.._..2(1. &._.> .4__oL.J. _ _._.Bllockk_.__.__ ...16� Subdivision Miami- 5ho =as
Street and Number where work is to be performed —No. _S. _ : Street.
State work to be performed and purpose of building (By Floors)_._:
New Building . Remodeling Addition__ __________________.. Repairs No. of Stories 1_
Size Septic Tank Type of Tank_._ Capacity Gals. __.....
Amount of Permit $
My Commission Expires
_Dist. Feet of T or ain Field from Well
Feet of Drain Tile
Nature of Water Supply: City—
Well City Size of Soakage Pit
_�
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 cmi-
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 agree to employ only such sub- contractors, on work to be performed under this permit, as an
licensed by Miami Shores Village.
/7
( Signed)
(Signed)
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 lac
therein by him stated are true.
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 f;Iu1
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWER6
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
UR
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTUREI
CONTR.
LI T
CHECK
n e
� 1
r
2
AS !J
1
r ��
/
7
/ SEPTIC
Zr
/
_
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
EATER
DEEP
WELL
SPRKLR.
SYSTEM
$WIM'G
POOL
N>ria.e.
�9 -
CONTR.
LIT
CHECK
I
/
/r' °'
5-
'1
Permit No. ___l 12
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date June _._4 2953
i
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
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 Divisior
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 Uaj.nes Cont. Co No Street
Registered Architect and /or Engineer
Employing Plumber's Name.. J. M.___ louncil No. Street
Location and Legal Description Lot_.._..2(1. &._.> .4__oL.J. _ _._.Bllockk_.__.__ ...16� Subdivision Miami- 5ho =as
Street and Number where work is to be performed —No. _S. _ : Street.
State work to be performed and purpose of building (By Floors)_._:
New Building . Remodeling Addition__ __________________.. Repairs No. of Stories 1_
Size Septic Tank Type of Tank_._ Capacity Gals. __.....
Amount of Permit $
My Commission Expires
_Dist. Feet of T or ain Field from Well
Feet of Drain Tile
Nature of Water Supply: City—
Well City Size of Soakage Pit
_�
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 cmi-
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 agree to employ only such sub- contractors, on work to be performed under this permit, as an
licensed by Miami Shores Village.
/7
( Signed)
(Signed)
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 lac
therein by him stated are true.
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 f;Iu1
materials and /or workmanship.
1
3' .
co
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