1201 NE 102 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 8 - 6 - 97 Job Address 1201 N.E. 102nd Street Tax Folio
Legal Description Historically Designated: Yes
owner/Lessee/Tenant DAVID PETTIS Master Permit # t 7 Cf
owner's A d d r e s s 1201 N . E . 102nd Street , Miami Shores ,F1 33138 Phone 305 - 754 -0754
ContractingCo. Coastal Plumbing Co. of Miami
Qualifier Robert E. Brincefield ss# 305- 651 -4429
state# CFCO- 19042 Municipal# 6264 competenc 6264 Ins Co Acord i a Ins. Agency
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Replace existing electric water heater
Square Ft. Estimated Cost (value) $200.00
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 re x_ lating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
o President Date
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Notary as to Otrvee an.d/os ' ; 1 ' * l ent ate
My Commissioi£ir�C 477159 n5do ; o
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FEES: PERMIT RADON
APPROVED:
Zoning Building
Mechanical Plumbing
C.C.F.
Address
285 N.E. 185th Street, Miami, F133179
/96.41frZ41/2
Signature of Contractor or Ow Builder
CIA ST 1
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Notary as to Con ct o> ► wne9- . ldiirr
My COMMiSSiOn pr esCC 477159
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71.1/1/i�STA , :'�
O
NOTARY BOND
Electrical
No
TOTAL DUE
x
Date
Date
Engineering
- -+
CLosrrs
BATH
Tuss
SHOWERS
LAVA•
TORIES
S
SLOP
LAUNDRY
TOSS
URINAL/
CATCH
BASIN
FLOOR
DRAIN
ORINKI NG
FOUNT' NS
TOTAL
FIXTURES
Coffin.
LIST
'
,
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
COMM
LIST
I !
CHICK
1/
ST AT e / F 0 °368 7, 47
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT p
Permit No..0 Iii �v� Date... - - S r G P T - I I dS
Owners Name and Address
Registered Architect and /or Engineer ,y.�
>E loyin Plumber•s ,/ 0 vE 61}-, c 50� /�4 A61
tocatit on anc Legal bescrt"ptit Lot- p
Street and Number where work is to be performed —No 1 ? 0 1 pp
State work to be performed and purpose of building (By Floors)_— .___`..
New Building - -___— __..- •---- ... - -•_ -- Remodeling -- Addition
Size Septic Tank._ Type of Tank__
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Wen .. ._.__.
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, 1 µ
COUNTY OF DADE. 1
iDA1 PETTES
(Signed)
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.
No„--2-1.3.....
v , i o�rtreet
Epp cis_ -o ' -5 .... # *1d/.
___� - - -- Repairs ,, No. of Stories..........
Subdivision
(si _ t '?&1c'Y ._
S treet ._I 2.01 '2 • C � 1
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 laax 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 arr
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 dep oses and says that he is the.. .__.._ .. _. _ _.... _..
of the above described construction, that be has carefully road 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
NOTE: A re-inspection fee of 11.00 will be made whoa wale sniupeotion V smade•neomeary by improper notice for inspection, or faulty
materials and /or workmanship.
2,0/1/S/ 2_J4:
/3 6
Permit No. I/ 2 O („
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 of 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 En
Employing Plumber's Name
Location and Legal Description Lot Q
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply
Z �AfFiount of Permit $__
ss.
Remodeling
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition
( Signed)
(Signe
Date__
No Street L 1 2.
No.- 7, 9
Block__ /if i Subdivision_ ! }• +
Street and Number where work is to be performed —No. /4 , -r 0 Street_L1/ 1`- / n A _
Yai' .
State work to be performed and purpose of building (By Floors)
New Building
Repairs
-1/
No. of Stories
Type of Tank___ _,Capaci Gals.
Dist. Feet of Tank or Drain Field from Well _ (,,�
11 Size of Soakage Pit f ob. __
1 5 ---
2— 7
Notary Public, State of Florida
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 corn,
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.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
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
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
DR INK ING
FOUNT' NS
��J�
Il N 1 , /� ,
l /'J �J
/ ,/ jam
TOTAL
FIXTURES
-_
CONTR.
LIST
/
I/7 �j
/ '
7�
__ ,1
r
7t
'l `_
/
CHECK
7..)
SEPTIC
TANK
SEWER
CONN.
GRAIN
FIELD
SOAKAGE
'PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
- WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
�,1 �
11,/VW' v< T.
CONTR.
LIST
CHECK
f i r'
.. _
..._.._.
..
/ P--0/
/3 6
Permit No. I/ 2 O („
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 of 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 En
Employing Plumber's Name
Location and Legal Description Lot Q
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply
Z �AfFiount of Permit $__
ss.
Remodeling
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition
( Signed)
(Signe
Date__
No Street L 1 2.
No.- 7, 9
Block__ /if i Subdivision_ ! }• +
Street and Number where work is to be performed —No. /4 , -r 0 Street_L1/ 1`- / n A _
Yai' .
State work to be performed and purpose of building (By Floors)
New Building
Repairs
-1/
No. of Stories
Type of Tank___ _,Capaci Gals.
Dist. Feet of Tank or Drain Field from Well _ (,,�
11 Size of Soakage Pit f ob. __
1 5 ---
2— 7
Notary Public, State of Florida
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 corn,
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.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
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
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.