561 NE 101 St (4)Si
Date 1/2-3/9 (p Job Address S I I ° • 1 O 1 S T Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant k d Master Permit #
Owner's Address S(, 1 ,J
Contracting Co. SE 4 oTA P -1 0' 3 i »& Address $ q 3 N E, - 11 i h sr M ,n ;
Qualifier k d ►'J v EA) T J
State # R f' O J 3 1' / 7 / Municipal # 000 XI l' Competency # ] FO c) 3 71 71 Ins. Co. K t.J • TN j r44.Jc
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN ROOFING PAVING FENCE SIGN
WORK DESCRIPTION R o C- 1 f li-r 0 SET Tv r3 F �c �T�= !� .c c sr 10 Or)
S E ;✓/1 T 15n GLVSr •T Sl L� ✓� T „),,c y
Square Ft. Estimated Cost (value) l t7 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.
/i) Y
-/ and/or Condo President
21,2_ 3 / s (
Notary as to Odvner and/or Condo President ate
My Commission Expires:
BARRY CERRATO
Notary Public, State of Florida
My Comm. expires Dec 22, 1997
No. CC338031
FEES: PERMIT ," L i. RADON
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1 ST.
e
C.C.F. ' ST' NOTARY TOTAL DUE L �-
Phone .. "7 S to — 0S
SS# ( ' }S Fs'
Signat u? f Contractor or Owner- Builder
2/ L y
Notary as to Contractor or Owner- Builder Date
My Commission Expires:.
BARRY CERRATO
Notary Public, State of Florida
My Comm. expires Dec 22, 1991
No. CC338031
3 9,201 cl
Da e
ITEM
BATH Tl8
UNIT
4
FEE
4 i6
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/METER CHANGE
`
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
(
404
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
-
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 FP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
I
/J
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SIPPLY 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
SW I If1I NG POOL
OUTLETS COM+IERC IAL
WATER SitRW£E Ri V i sv et
#7
TUBES
SEWER CONNECTIONS
G/
SIGN TRANSFORMERS
UTILITY-SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA -•
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
PULP & 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
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
Date / / 4 Job Address (ol X/e, /f9AC7 • Tax Folio /M2. 06-®/ M
l 7 /l 0 0
Pin/ 221c) cie4
Legal Description of-e
Owner / Lessee
Owner's Address f�l �� 2/ Sf' Phone
Contracting Co. LI4I 6,f'Fic) /24066- Address »o 56•)- 5 - 3 cS Sd�
Qualifier c 1c4,,i l `,ld 6-ea P SS# `(/ Phone '302/— 68
State Ii (TC0 *.,2 ?3Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIG!
WORK DESCRIPTION RC f►'l^ d.e 6-- J76 1J
Square Ft. - Estimated Cost(value) J dazu,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO Dc
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUI
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws regulating construction in this jurisdiction. I understand that separat
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 wil
be done in •'pliance with all applicable laws regulating construction and zoning. Furthermore,
authorize above -named contractor to do the work stated.
Signature/of o o
Date:
N•� as to er and ■111..
4%.
My Commission Expires:
** *
APPROVED:
* *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/
Tenant g - '60! H J2..
Mechanical
r and /or Condo President
Master Permit
Signat
Date:
.�� ..�.�semr
e of Co 'act r
r- Builder
tar as to Co
My Commission E
RADON C c.carr NOTARY /a TOTAL DUE 524V
Fire Other
Zoning Building Electrical
�lumbin_ Engineering
•
!Y'"'L' CHURCH
* * * * * * * *
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 AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
-
RANGE TOP
UNDERGROUND TANKS
LAVATORY (j os. .c.Nl�/)
j
OVEN
ABOVE (MOUND TANKS
LAUNDRY TRAY u
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER p., 5 )
l
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER &of)
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE 02,46)
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 If
FIRE SPRINKLER SYSTEMS
URINAL /
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOT ORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST. (pF S
(
GENERATORS TRANSFORMERS
HEATER - REPLACE l
GENERATORS TRANSFORMERS
1
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
(
0(
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 8 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
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
Permit No. ___-- -1 -o$
Registered Architect and /or Engineer
Employing Plumber's Name
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot
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 1(u°— "ic � '� No Street
Location and Legal Description Lot- .___._- _.__._ _ _ Block_______. _._____.__ Subdivision_
Street and Number where work is to be performed —No. . S /
State work to be performed and purpose of building (By Floors) / _
New Building Remodeling Addition__.___________- __._____ Repairs
Capacity Gals
Size Septic Tank Type of Tank_
Feet of Drain Tile . Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well . — Size of Soakage Pit
o v
Amount of Permit $- - _ -__ -- __ - -- ��-------- - - - - -- — - — —_ _f_ (Signed).
No. - -- _ ._---- _- - -__._ Street__
( Signed
Date
9_ 3-z
No. of Stories
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 Pennanent 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 art
licensed by Miami Shores Village.
STATE OF FLORIDA, u.
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 tat•
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
OBI NKI NO
FOUNT' NS
TOTAL
FIXTUREI
CONTR.
LIST-
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No. ___-- -1 -o$
Registered Architect and /or Engineer
Employing Plumber's Name
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot
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 1(u°— "ic � '� No Street
Location and Legal Description Lot- .___._- _.__._ _ _ Block_______. _._____.__ Subdivision_
Street and Number where work is to be performed —No. . S /
State work to be performed and purpose of building (By Floors) / _
New Building Remodeling Addition__.___________- __._____ Repairs
Capacity Gals
Size Septic Tank Type of Tank_
Feet of Drain Tile . Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well . — Size of Soakage Pit
o v
Amount of Permit $- - _ -__ -- __ - -- ��-------- - - - - -- — - — —_ _f_ (Signed).
No. - -- _ ._---- _- - -__._ Street__
( Signed
Date
9_ 3-z
No. of Stories
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 Pennanent 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 art
licensed by Miami Shores Village.
STATE OF FLORIDA, u.
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 tat•
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 foul
materials and /or workmanship.
Permit No. SL r Z
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subfnitted 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 r
Registered Architect and /or Engine
Employing Plumber's Name
Location and Legal Description Lot
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
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
1
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
l•' e t No. __ 7(.2__5__1 Street 11__ Z , "`-
Subdivision
( Signed)
No ___ Street____ • / UC___I Q ' •
Date 97
Notary Public, State of Florida
No. of Stories
I Amount of Pe it $___ (Signed )
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 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 s un er this permit, as are
icensed by Miami Shores Village.
Mas)gPlumber.
, ATE OF FLORIDA, 1 ss.
' NTY OF DADE. J
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
\ well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
'above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
'1y him stated are true.
My Commission Expires
A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
ad /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT' NS
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
\ I
-
CHECK
Permit No. SL r Z
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subfnitted 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 r
Registered Architect and /or Engine
Employing Plumber's Name
Location and Legal Description Lot
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
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
1
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
l•' e t No. __ 7(.2__5__1 Street 11__ Z , "`-
Subdivision
( Signed)
No ___ Street____ • / UC___I Q ' •
Date 97
Notary Public, State of Florida
No. of Stories
I Amount of Pe it $___ (Signed )
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 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 s un er this permit, as are
icensed by Miami Shores Village.
Mas)gPlumber.
, ATE OF FLORIDA, 1 ss.
' NTY OF DADE. J
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
\ well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
'above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
'1y him stated are true.
My Commission Expires
A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
ad /or workmanship.