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640 NE 101 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE // Sr- pgopcR,Ty Co& r —A'o� No. // Date 999 Job Address r `7 /0 S Tax Folio //- 3,7 0 6 - 0/2 - 090 / A / P` Awn. SN ceEs 19/3/ 5 Legal Description L€73`/ 9- E7 o -' S 84 K / is" s0 Z e .. Qwner/i.essee /Tenants X0 -- e) h vi 6Vcc h cC ri usir 7 Q;s �u�iast Permit # 3 97 Owner's Address CO �'). C: /6 ( S7 - Phone ° - - 7s/ Contracting Co. X e- A/ V(L ELL ()Rs. C dress ( (OS A' t^' / a/ 5 T / t / Rol Qualifier P4 , L- c' A- (e Kj w SS# Phone d r l 5 f d� P < s State # � VI D p O a. 9 Municipal # 017 Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �=iJt �S � t hew J/p r S y sle Square Ft. Estimated Cost (value) 4/O 0 a d 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. Notary as to My Commission Expires: FEES: PERMIT 13 APPROVED: Zoning Mechanical Building Plumbing d/or Condo President Date ' Dagoberto F Guardia * .,. =% *My Commission CC7$0345 Condo President Jane 11 RADON C.C.F. Signature of Notary as to My Commissio NOTARY Electrical Owner - Builder Date ZOOZ'll aunrse11dn3 r d" "4, 9/1O9L33 uotsspuwo3 ityy4c ammo doi+agoBep er- Builder Date BOND —7 C O TOTAL DUE Structural Engineer llito of Miami Shores JOB i.Z ra 7 _ ADDRESS INSPECTION ' .vn ")‘ .0n c3 .z 9 ----- TIME READY a c c N° 4101 REMARKS INSPECTOR DATE "At- Vit 4je of Miami Shores t- JOB ` N9 3787 ADDRESS INSPECTION • TIME READY REMARKS ,A- \TSPECTOR DATE e - 5 --(-- MIAMI SHORES VILLAGE. FLORIDA IUILDING ❑ ` LECTRICAL ❑ DATF 195. 'LUMBING �— PERMIT N° 3006 Contractors 1.1 , License No. :OOFING ❑ ❑ Work to be performed under this Permit ?wner of ; uilding ' • ':a -rchitect : ontractor r Builder egal )ascription ddress of uilding i 06 .l N9 1 J 4. 4 , 3 Subdi- vision r _, Value of Project $ Amount of Permit $ 1 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 erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, swings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any he 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 anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations -rtaining to the work covered hereby whether shown on the plans or drawings or in the statements or specffications and that he assumes responsibility for work one 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 :rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY ems Permit 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 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 No. ______________ _ Street Registered Architect and /or Engineer ..... ____— ______�------ - - -___ Employing Plumber's Name _ No._ Street Location and Legal Description Lot _ _,. t '"�s.. � ___ Blocti _ Subdivision � � Street and Number where work is to be performed —No .‘. 4' , ,ef ` _./ rv' ,,- greet '` State work to be performed and purpose of building (By Floors)_ New Building l _ Remodeling_____ _ Addition______.__.____ ____.. Repairs.__ No. of Stories_ Size Septic Tank ----------- - - - - -- -Type of Tank Capacity Gals Feet of Drain Tile ___.________ '1 __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. _ —___ Size of Soakage Pit Amount of Permit $ / STATE OF FLORIDA, t es. COUNTY OF DADE. ( Signed) - -_ (Signed)._ Date P mbing hhspector. The undersigned applicant for this building permit does hereby certify that he understands and accept 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 under this permit, as are licensed by Miami Shores Village. 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 Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re inspection is made by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBE SHOWERS LAVA• TORIES SINKS INK SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS '. TOTAL FIXTURES CONTR. LIST CHUCK i I ' , _ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP Siarract HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LINT -- CHECK .;t ./ , 1 ) Permit 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 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 No. ______________ _ Street Registered Architect and /or Engineer ..... ____— ______�------ - - -___ Employing Plumber's Name _ No._ Street Location and Legal Description Lot _ _,. t '"�s.. � ___ Blocti _ Subdivision � � Street and Number where work is to be performed —No .‘. 4' , ,ef ` _./ rv' ,,- greet '` State work to be performed and purpose of building (By Floors)_ New Building l _ Remodeling_____ _ Addition______.__.____ ____.. Repairs.__ No. of Stories_ Size Septic Tank ----------- - - - - -- -Type of Tank Capacity Gals Feet of Drain Tile ___.________ '1 __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. _ —___ Size of Soakage Pit Amount of Permit $ / STATE OF FLORIDA, t es. COUNTY OF DADE. ( Signed) - -_ (Signed)._ Date P mbing hhspector. The undersigned applicant for this building permit does hereby certify that he understands and accept 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 under this permit, as are licensed by Miami Shores Village. 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 Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re inspection is made by improper notice for inspection, or faulty materials and /or workmanship. 6 ^ 2 A;