553 NE 101 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Oh Job Address S7573 NL— /0( Cr Tax Folio 1/ 3200 '"OI7- /12-0 °?
J ��11
Legal Description Lam II " 11 4- 04-5 if).- LET / � 4 Loc. K � Sv6. -/ „,, 4,, Si+bec• Si-ft:- L/
Owner / Lessee / Tenant '& 4 i;--0 Master Permit # f X
Owner's Address G A' (0/ S T Phone 7 56 - 07 //
Contracting Co. /< A /IIL 04n... ,�ttiLry �,,,� Address
Qualifier 41■/ SS# / Phone 76 q—Z 5 - Zrr1
State # �R �� Municipal #00"oZ5 Competency # I V 7 0/6 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 2-
_VU
Square Ft. Estimated Cost(value) It /7 S 5
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 constru _tion and oning. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or
Date: % /'y
ry is to Owner a
My Commission Expire
** * * *
Condo President
'e JOSEPHINE CHURCH
otar &,t- unur.S ate or rioriaa
C6FRAcll rd 30, 1996
No. CC197545
-t- SP/cr ,' g Lac S /sT Tux-
FEES: PERMIT /73 RADON C.C.F. I6 r7
APPROVED:
Fire
Zoning Building
Mechanical Plumbing ”
Da p
Date: "� //
y 'tar• as to
y Commissio
/7.47.ae'
Ji PHINE CHURCH
%!, . %+:-.b Public Stat of Florida
. �. .No. CC197545
NOTARY 4, TOTAL DUEv / 4497
)so Ncv /jq Si
A114-41 /
ontractor or Owner Builder
**
Other
Electrical
ngineering
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 Division
of. Miami Shores Village shall be complied with, whether berets specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , _ /
Owner's Name and Address I / T �' /n 1 i / No. d -----5 N 6- Street..X� 57
.. _.._ ..
Registered Architect and/or Engineer t c 1 d n at/had 2
I EmploYIS Plumber's Name _ r a Na. . ..a . .... Strut —._ .......A....
// Lor Le g al 'bescti p con Lot e = �. 4 ij / / B SubdivWonf�AP Pi !�1 �-
Street and Number where work is to be performed —No 6.--S.-- : .//r— /0 / 3 iiiree<
State work to be performed and purpose of building (By Floors) __. 2422. — 6 q' _ D.l> .? _` _L c
New Building. _. Remodeling—_- _- __.__._ -..- Addition. .__ Repairs s til of 5taries........
1 LI-
Amount of Permit 4_1 1
1 Size Septic Teak__ Type of Tank —
O Feet of Drain Tile rust Feet of Tank or Drain Field from Well _.__..__
Q Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing 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 5988, Compiled General Laws of Florida Permanent Supplement, and her 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 aril-
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, Ks are
licensed by Miami Shores Village
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
0 y97
Date
Notary Public, State of Florida
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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 $1.00 will be made whoa mob roasupooti et to saade•aaoemery by Improper nodal, for bespectlon, et faulty
materials and/ca worlomanship•
CI."'"
BATH
TOSS
S
LAVA•
TOR
41".
SLOP
SINK[
LAUNOR
Tuna
URINALS
CA
BAaIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
TOTAL
FIETURE•
CONTR.
LIST
/
/ I[[
/
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
W[LL
6
SYSTEM
SW$M'0
POOL
Comm
Liss
Caeca
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 Division
of. Miami Shores Village shall be complied with, whether berets specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , _ /
Owner's Name and Address I / T �' /n 1 i / No. d -----5 N 6- Street..X� 57
.. _.._ ..
Registered Architect and/or Engineer t c 1 d n at/had 2
I EmploYIS Plumber's Name _ r a Na. . ..a . .... Strut —._ .......A....
// Lor Le g al 'bescti p con Lot e = �. 4 ij / / B SubdivWonf�AP Pi !�1 �-
Street and Number where work is to be performed —No 6.--S.-- : .//r— /0 / 3 iiiree<
State work to be performed and purpose of building (By Floors) __. 2422. — 6 q' _ D.l> .? _` _L c
New Building. _. Remodeling—_- _- __.__._ -..- Addition. .__ Repairs s til of 5taries........
1 LI-
Amount of Permit 4_1 1
1 Size Septic Teak__ Type of Tank —
O Feet of Drain Tile rust Feet of Tank or Drain Field from Well _.__..__
Q Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing 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 5988, Compiled General Laws of Florida Permanent Supplement, and her 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 aril-
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, Ks are
licensed by Miami Shores Village
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
0 y97
Date
Notary Public, State of Florida
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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 whoa mob roasupooti et to saade•aaoemery by Improper nodal, for bespectlon, et faulty
materials and/ca worlomanship•