640 NE 101 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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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�
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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
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TIME READY
REMARKS
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\TSPECTOR DATE
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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
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DRAIN
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TOTAL
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SEPTIC
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GREASE
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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.
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