59 NE 101 St (3)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Job Address
Owner's Address
Contracting Co.
Qualifier /41 N. IJtJL(k
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION
Square Ft.
Sigir.:ture
Data:
Legal Description LOT /Q,FJ1 ' ? // /SS- SS ?T /4 (D1 aster Permit /
Owner / Lessee / Tenant MP1' ezps-hucck
State# Competency# 6 F Co379?
er
f Owner",and /or Condo
Af
ary;`as to O'Y wne and /or Condo
Commission "ExP‘ireieBTARY PUIJC STATE OF FLORIDA
My
*
BONDED THRU NERAL I . UND.
PERMIT FEE: APPROVED: Fire
President
President
WOcCOPPISSII AP%.17,1995
(OWNER TO RETAIN COPY)
Address
Tax Folio // ,326 /3 /5
phone
SS # - phone f,�- J .1R5
Address
Address
Address
G
Estimated Cost
Ins. Co.
BUILDING ELECTRICAL ( PLUMBING) MECHANICAL PAVING FENCE SIGN
64/A
40
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. 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 autorize the above -named contractor to do the work stated.
Signature of Contractor or Owner- Buiider
Date:
tary as to Contractor or Owner- :uilder
My Commission Expires NOTµr RNILIt tTRTt IF 1r(
COIMI SSdcON !%T. NkR.17 1G
BONDED THRU GENERAL 11113. U .
Other
Zoning Building 4lectrical
Mechanical Plumbing Otgin eer i ng
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BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
wilding
Lot
Fl
PERMIT N° 10189
Work to be performed under this Permit
1
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
fit
Contractor's
License No
Bl.
Subdi-
vision
BY
sti . 1951►
Value of Amt. of
. 1 Project $ Permit $ : j
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
refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
:wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
.e 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
nted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
.aining to the work covered hereby whether shown on the plans or drawings or in the statement or specifications and that he assumes responsibility for work
e by his agents, servants or employees.
Signed • .+�w"�— � �„ BY
IN EC OR
In consideration of the issuance to me of this permit I agree to per rm the work covered hereunder in compliance with 41S dinances and regulations
uning thereto and in strict conformity with the plans, drawings, statem or specifications submitted to the proper authorities.. f Miami Shores Village.
ccepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
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 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
Registered Architect. and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors _
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
a
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. � ___ Street e /
No.__ 2-c5;9 Street _ �1
Block Subdivision
Street ,( (• /��
( Signed -
Date ��� f d?, 2- S�
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that 1 nderstands and accepts his obligatig, f'is an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled beneral Laws of Florida Permanent }Ipplelnent, 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 ) ,t
My Commission Expires Notary Public, State of Florida
Master Plumber.
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 when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /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
SW IM'G
POOL
CONTR.
LIST
CHECK
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 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
Registered Architect. and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors _
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
a
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. � ___ Street e /
No.__ 2-c5;9 Street _ �1
Block Subdivision
Street ,( (• /��
( Signed -
Date ��� f d?, 2- S�
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that 1 nderstands and accepts his obligatig, f'is an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled beneral Laws of Florida Permanent }Ipplelnent, 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 ) ,t
My Commission Expires Notary Public, State of Florida
Master Plumber.
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 when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
•