1250 NE 102 St (12)Date 6 -27 -00
FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 1250 N.E. 102nd Street Tax Folio
Legal Description
Owner/Lessee /Tenant Maria Nardo - Bona l l Master Permit # 7/ 'r
Owner's Address 1250 N.E. 102nd Street, Miami,
ContractingCo. Coastal Plumbing Co. of Miami
Qualifier Robert E. Brincefield
state # CFCO -19042 Municipal # 6264
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL 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 regulating
construction and zonin: F - I authorize the above-named contractor to do the work stated.
Notary as to Owner*,. it NOe '+y..
My Commission Expires: £00Z '81 aunc
IWI
S321IdX3 b166£9DD # NOISSIWWOD AN ' ,
JeAo>S oPPutad •' :;`"
V7
5 o RADON
APPROVED:
Zoning Building
Mechanical Plumbing
6 -27 -00 -.
C.C.F.
Historically Designated: Yes No
F1 33138 Phone 305- 754 -9005
Address 285 N.E. 185th Street, Miami, F1 33179
ss#
Competency # 626 Ins. Co. Collinsworth, Alter,
et al
Address
Address
-Op
Phone
NOTARY
Electrical
Structural Engineer
Signature of Contractor or Own r Builder
305 - 651 -4429
6 -27 -00
Date
6 -27 -00
Notary as to Contractor or • er - Builder Date
My Commission Expires: ,�..
;� •Y" �" Patricia Stover
t:�;
_ '•� ..: MY COMMISSION # CC839914 EXPIRES
-. June 28, 2003
' .'� BONDED THRU TROY FAIN INSURANCE, INC
BOND
TOTAL DUE
.UILDING
LECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
❑
° PERMIT N9
ir
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
Signed:
Work to be performed under this Permit
1
j r _
9771
Subdi-
vision
r
L
DATE f - .2 t
Sq. Ft
Value of
Project $
Contractor's
License No
Amt. of
Permit $ 2,
BY AUTHORITY
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
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time 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
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
f
INSPECTOR ,X
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
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
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 Dean R._ C1auSSen — N 0 NE_102 St. Street
Registered Architect and /or Engineer_____________
Employing Plumber's Name 'OQ _SiaI'j.Itk er___C4_.._ — _ --- ___ - -- No.__ 880 _ NW 54th St 6treet. ._.__-----
Location and Legal Description Lot__.___._____— ___— ________,N _ Block Subdivision
Street and Number where work is to be performed — 1250 NE - x,02 Ste Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling___ ___ Addition.____ —. Repairs
Size Septic Tank
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r' MIT
Type of Tank Capacity G=as.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Amount of Permit $1 - -_8 +00 ----------- - - - - -- — -- (Signed)
__Size of Soakage Pit
1/7/60
Date
No. of Stories
Plumbing Inspecto`i' ---
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors ei ployed 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.
tom(/ - -a - �✓ y ' i
(Signed)._
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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
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
S
LAVA-
TORIES
S INKB
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT - 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
2
X
CHICK
If
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 Dean R._ C1auSSen — N 0 NE_102 St. Street
Registered Architect and /or Engineer_____________
Employing Plumber's Name 'OQ _SiaI'j.Itk er___C4_.._ — _ --- ___ - -- No.__ 880 _ NW 54th St 6treet. ._.__-----
Location and Legal Description Lot__.___._____— ___— ________,N _ Block Subdivision
Street and Number where work is to be performed — 1250 NE - x,02 Ste Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling___ ___ Addition.____ —. Repairs
Size Septic Tank
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r' MIT
Type of Tank Capacity G=as.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Amount of Permit $1 - -_8 +00 ----------- - - - - -- — -- (Signed)
__Size of Soakage Pit
1/7/60
Date
No. of Stories
Plumbing Inspecto`i' ---
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors ei ployed 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.
tom(/ - -a - �✓ y ' i
(Signed)._
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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
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.
Permit No 9 7 /
Size Septic Tank
Feet of Drain Tile._
Nature of Water Supply Well
4)
�l g
Amount of Permit $ ............... ___________________
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
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._ -_ GIC� - 1 _ _ .- _ No.__ .__ -__ Street.
Registered Architect and /or Engineer_---_---_-_ ______________________._.______
No._ Street_ Employing Plumber's Name_ __ __ _ I ' � `� ‘ ��
Location and Legal Descript Lot. - -_ -- _ -____ - _ - ___ _Block / 8 Subdivision.
Street and Number where work is to be performed —No' J 7' . 0 ..lt/6 / O 2 s treet
State work to be performed and purpose of building (By Floors). New Building ✓ __- Remodeling ____ Addition____ Repairs No. of Stories.._ . /_.....- . _
Type of Tank- _ Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
- ---- --- _----- _ -__ -- - Size of Soakage Pit
__-_ (Signed)
.?
( Signed)___
Date / cS --
Notary Public, State of Florida
-/ C ' ..
s� 4�
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hisibligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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 worl/ such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on w s k to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, t se.
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_
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
SINKe
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
3
/
/
.3
/ -
—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
30 R-
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
piv"-
4/4140.0
I
-`
CoNTR.
LIST
-
CHECK
Permit No 9 7 /
Size Septic Tank
Feet of Drain Tile._
Nature of Water Supply Well
4)
�l g
Amount of Permit $ ............... ___________________
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
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._ -_ GIC� - 1 _ _ .- _ No.__ .__ -__ Street.
Registered Architect and /or Engineer_---_---_-_ ______________________._.______
No._ Street_ Employing Plumber's Name_ __ __ _ I ' � `� ‘ ��
Location and Legal Descript Lot. - -_ -- _ -____ - _ - ___ _Block / 8 Subdivision.
Street and Number where work is to be performed —No' J 7' . 0 ..lt/6 / O 2 s treet
State work to be performed and purpose of building (By Floors). New Building ✓ __- Remodeling ____ Addition____ Repairs No. of Stories.._ . /_.....- . _
Type of Tank- _ Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
- ---- --- _----- _ -__ -- - Size of Soakage Pit
__-_ (Signed)
.?
( Signed)___
Date / cS --
Notary Public, State of Florida
-/ C ' ..
s� 4�
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hisibligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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 worl/ such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on w s k to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, t se.
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_
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.