370 NE 101 St (6)Date O /
Si
FEES: PERMIT
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION shed- MIAMI SHORES VILLAGE
Job Address 8 /J 0 /01 ���"=- Tax Folio
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
construction and zoning. Furthermore, I authorize the above -named contractor to the wo stated.
411 _ ...1 1 _x.
Jr
f owner and/or
e`r1157 F i ..::gnu . sident
My Ciss xpiresN°. CC 919427
RADON
Plumbing
Date
a7o
C.C.F.
NOTARY
it -°(a 0135a -'1
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant E71 Zl Oth ( EAC,I i'5Ov1 Master Permit # q 2-
Owners Address 310 AI6 <s// ee/ Phone M5 5 D D CU
Contracting Co. L■l g m, Shoreb'I (1/flh) Address 9X MW 1 **
Q ualifier rf f cJ / 1/1 I, r] SS# gol- -1 ? -60 Phone ' 757 ..9
State # ( C:O /9X Municipal # Competency # Ins. Co. ZeniA tatriat
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING W.
NG ELECTRICCAL LUMBING MECHANICAL J / ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Waer £ P./ LI j Cr r Ace
Square Ft. Estimated Cost (value) ° ("Q '
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.
e in compliance with all applicable laws regulating
BOND
TOTAL DUE /
Date
Building Electrical
Structural Engineer
ITEM
BATH TUB
UNIT
I
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 AMPS
DUCT WORK
FLOOR GRAIN
SERVICE REPAIR/I€TER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR 0
RANGE TOP
UNDERGROUND TANKS
LAVATORY
li
OVEN
ABOVE GROUND TANKS
IAUNCRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
I
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE K+tc6n
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTCRS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
.
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
II
MOTORS OVER 100 HP
VIOLATION
INOIRECT 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 _ -_:
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
0
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
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE
PLUMBING ® PERMIT N° 8224
ROOFING ❑
❑ Work to be performed under this Permit
Owner of l� , •,
Building i€ + c ' .r
Architect
Contractor
or Builder
Legal
Description
Address of
Building
"
Lot
/
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of
Project $
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 application
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 plans or drawings or in the statements or specifications and that he assumes responsibility 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.
Contractor's
License No C "` 4 t
Amt. of
Permit $
}1'
BY AUTHORITY
1954_
� Z
Permit No
Registered Architect and /or Engineer ______
dr,
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City —Well.
Amount of Permit $ _ ✓ -- - - - - --
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
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____ l¢ 4 ,�1�___ d!_C.Li' � / _ ' No._ __. _ Street d / s `
Location and Legal Description Lot_____ ..... 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
Type of Tank
( Signed) _
Date
Zoe/t, .de
Subdivision
Street_.
/ V._
9
Street
Repairs No. of Stories.
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
_ Size of Soakage Pit
It
Plumbinh=Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, 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, .. :rk to be • rformed under this permit, as are
licensed by Miami Shores Village.
(Signed)...
Master Plumber.
STATE OF FLORIDA, ( au
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 .necessary by improper notice for inspection, or faulty
materials and /or workmanship.
7
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuef
U RINALS
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'S
POOL
/
/
- ---
CONTR.
LIST
CHECK
� Z
Permit No
Registered Architect and /or Engineer ______
dr,
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City —Well.
Amount of Permit $ _ ✓ -- - - - - --
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
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____ l¢ 4 ,�1�___ d!_C.Li' � / _ ' No._ __. _ Street d / s `
Location and Legal Description Lot_____ ..... 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
Type of Tank
( Signed) _
Date
Zoe/t, .de
Subdivision
Street_.
/ V._
9
Street
Repairs No. of Stories.
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
_ Size of Soakage Pit
It
Plumbinh=Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, 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, .. :rk to be • rformed under this permit, as are
licensed by Miami Shores Village.
(Signed)...
Master Plumber.
STATE OF FLORIDA, ( au
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 .necessary by improper notice for inspection, or faulty
materials and /or workmanship.
7
Permit No. . _
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 al
building during progress of work.
Owner's Name and Address. 58012/1/ No Street
Registered Architect and /or Engineer
Employing Plumber's Name 0;:?./ . A-- 1 4.0:1,6M/6- No..
Location and Legal Description Lot______._.._........ _Block—
Street and Number where work is to be performed —No S ® A/4. / / °o
State work to be performed and purpose of building (By Floors)_
New Building __ _ Remodeling __.. Addition__. Repairs._
Amount of Permit $_. _____.
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed ) _
a Street.
Date "! ` - Y
Street
Size Septic `Tank sd Type of Tank__
- _�_
IZis�Feet of Tank or Drain Field from Well
Feet of Drain Tile
__. ..- .__..._
Nature of Water Supply + Well _ _ _- _. Size of Soakage Pit
Capacity Cals.
Subdivision
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as nn 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 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 sub- contractors, on work to be performed under this t�ernmit, as art
licensed by Miami Shores Village.
SD
•
Before me, the undersigned uthority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
/ Master Plumber.
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..ul
materials and /gar workmanship.
CLOSETS
BATH
TUBS
SHOW[R6
LAVA.
TORIES
SIN"
SLOP
SINK•
LAUNDRY
Tues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT'NS
a- -
If, e'
TOTAL
FIXTURE'
-
CONTR
LIST
.h
y�S
)
f -
3
/
ry
�l 7
/A l
-
CHECK
yy,�
07 .5 1 . /
7
l
4
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
6/11FOR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
w kArQ
LIST
CHECK
/
let;
/
At
s
C)
7
Permit No. . _
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 al
building during progress of work.
Owner's Name and Address. 58012/1/ No Street
Registered Architect and /or Engineer
Employing Plumber's Name 0;:?./ . A-- 1 4.0:1,6M/6- No..
Location and Legal Description Lot______._.._........ _Block—
Street and Number where work is to be performed —No S ® A/4. / / °o
State work to be performed and purpose of building (By Floors)_
New Building __ _ Remodeling __.. Addition__. Repairs._
Amount of Permit $_. _____.
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed ) _
a Street.
Date "! ` - Y
Street
Size Septic `Tank sd Type of Tank__
- _�_
IZis�Feet of Tank or Drain Field from Well
Feet of Drain Tile
__. ..- .__..._
Nature of Water Supply + Well _ _ _- _. Size of Soakage Pit
Capacity Cals.
Subdivision
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as nn 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 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 sub- contractors, on work to be performed under this t�ernmit, as art
licensed by Miami Shores Village.
SD
•
Before me, the undersigned uthority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
/ Master Plumber.
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..ul
materials and /gar workmanship.
•
L.>
,;■
CONTR. .
TYSe S
LAVA• S
SINKS .
SLOP L
LAY •fi- C
C,. +. -^ -
- -. • D
DRINK'S• T
..
TOTAL.,
Permit No..1..i_9 4" Date 2 ° 8 9 �
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
Amount of Permit $
Size Septic Tank_ _.._ __._....._--._.--___.... -_-_--.Type of Tank.
Feet of Drain Tile._.__ _ . - -. _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: Ctty—Well. _... Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. Street.
Registered Architect and /or Engineer-_-_.-, —
lli Employing Plumber's Name f ' h ��� At r 6, a No.. .M __ __. Street . --_-__----....__.-_.-..-...
Location and Legal Description Lot. Block Subdivision.- __,.- .._- __...- .._.._- ..___._..
Street and Number where work is to be performed —No 3 In o_ _ / 4/87 Street ....--- ._._...._.._._
State work to be performe8 and purpose of building (By Floors) _-- .-_-.._..____-_____--. -._
New Building_ _ __ Remodeling —.__ Addition.
�--� (sue)
(Signed)
Repairs..
Capacity Gals
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 5968, 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
requhed 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
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
No. of Stories.
Plumbing Inspector.
�Il� t rte,
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 Comn Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•neoesaary by improper notice for inspection, or faulty
materials and /or wcrlomensbip.