210 NE 102 St (5)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
. ,, 305- 795 -2204
Building Inspection Request
Dat� Time
Type Insp'n T ( nc` QOi € U u' '°
Permit No. l
Name Yili
Address O'
Company fC& W.Yrr) &CAS
Phone # SQS 7 S O 9 S 1
For Inspector: E
Approved
Correction
Re- Insp'n Fee
Name & Date
It 9 c/ 7-- S,. t`l 4°
.Vya- ,z°G a/') 1' Z
1'-
79
i
IAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
AP PLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement ur the plans and specifications herewith submitted for the build
ine 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 the work.
_._...___. __........ t d ...� 2 8 , 19 80
2
n ' Date..
Owner's Name and Address . 2 11 0 �( Ft €3. _ No q rr?.. & .5.._.. Street..... .IS.Sa fj. ..e..!�0
Registered Architect and /or Engineer.... • s.IB.Ai L .YI N) Z C1.1) 11 Z- • £ A /Q.1 1
Name and address of licensed contractor ..At.11Akf1:4.6 c.1 5`g►Sa `Qt....N -V.?_ sh,..R \ ‘ -S •
Location and legal description of lot to be built on:
Lot 1 Block . P12-11.4A.6
Subdivision �,.Z.:_........_ — .._.._
Street and Number where work is to be done a 1.Q t._.�a .. .1'..= ...... �.._..__
State work to be done and purpose of building (by floors) ? 5 � qc1.\ ...._..__
and for no other purpose.
New Building V Remodeling
eling Addition Repair
To be constructed of .RfaX :•. aind of foundation e�
Estimate Total cost of improvements $ f?S?..Q Amount of Permit 3. l
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
lfaxirnum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to.
The undersigned applicant for this building permit does hereby certify that he understa
of Labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled C
and has complied ssith the rovisions thereof, and will require similar compliance From all
in the work to be performed under this permit; and will post or cruse to be posted for ins
or notices as arc required by the Act. The undersigned agrees to employ only such su
permit, as are licensed by Miami Shores Village.
Remuks (Signed
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved
(Signed)
Date
No. of Stories
vering
n.
Wane
ors e
ork
ors Pe
ntra
f the
to
accepts his o
aws of FI
tors or sub -
on the site
rs, on wo
an employer
implement,
yed by him
ul)lic notice
orme• under this
Before me, the undersigned authority, a notary public, duly authorizcd to administer oaths and take acknowledgments, personally ap-
peared
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. �j
Permit No.._. 4 Date... to) •� r' Read, Sworn to and Subscribed before me.
to me well known,
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member _ Member
Member .. .. _....._. Member
Council Approved Date Disapproved Date
MUTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Plannir;; Board.
A re•impcction fce of 51.00 will be charged when such re -ins, c tion is made necessary by Improper notice for inspection or faulty
materials and /or workmanship.
Date tat i4
Miami Shores Village
Building and Zoning Department
Attention: Building Official
SWIMMING POOL. _OWNER'S..CERTIFICATION
I certify that I am the legal owner of the property described as
t.or I i6loce. a5 0Aza / Sup. , located at Ic) ' e. 10 2 s �--
In accordance with Section 33- 12(f), Code of Metropolitan Dade
County, I certify that I understand and agree that the swimming pool
to be constructed at the above address cannot be used or filled with
water until`,a separate permit has been obtained for an approved safety
barrier, and such barrier erected, inspected and approved.
I further understand that this certification, however, does not
eliminate the need for obtaining a permit and erecting an appr ed barrier
pvior to final inspection and use of the pool.
Legal Owner
Note: This certification is to be submitted with a swimming pool
permit application in duplicate.
CLOSrrs
BATH
TUBS
SHOWER[
LAVA•
TORIES
SINK•
SLOP
SINKS
LAUNDRY
Toss
URINALS
CATCH
eASIN
FLOOR DRINKING
DRAIN FOUNT'Ne
1
TOT, -i.
FItTI RES
CONTR.
LI'T
j
CHECK
JT
_
AO
T
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
H
DEEP
WELL
K
BPRLR.
S
SWIN•O
POOL
� w �
—
H
i L w
CHECK
1
Penni: No. .3d -. —
:eppllc :.rum is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.na...d for the building or other
rtructurc herein described. This application is made in compliance and conformity with the Building Ordinance of Mi; ••f Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulaticr.'. of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec ficatlons must be kept at
building during progress of work.
'Avner's Name and Address Ale.11.&&12 2 _..,..__.._. No.g _ Street_.$.1Kfi511. - '6L. O•
.egist [red Architect and /or Engineer ,LO AC►s,►tvt E . 1 tog L
imploying Plumber's Name QU)
Location and Legal Description Lot. 1 Block 3 S Subdivision.._.1ik24141-3e..__ ._.
Street and Number where work is to be performed —No 2 I O �C1?. -- Street 40 2. 4T •.
State work to be perform d and purpose of building (By Floors) SW.s` 'artle4S'!► __ 0l _..__ tls.a4 %%"`
New Building .............. Remodeling__ _ — ....._._ Addition.____.... Repairs No of Stones
Size Septic Tank_ - - -- •----- ....----------- . - - - - -- - Type of Tank
Feet of Drain Tile.__.___ __ — ._.__—Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well..___ .-- _- ._- .•-- -. - - -_ -- _--- __ - - -- .•Size of Soakage Pit
Amount of Permit $ 4 •0 O
The undersigned applicant for this building permit does hereby certify that he understands and accept
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Flori
1.lied with the provisions thereof, and will require similar compliance from all contractors or sub -contr
performed under this permit; and will post or cause to be posted' for inspection on the site of the
required by the Act. The undersigned agrees to employ only such sub - contractors, on work t
licensed by Miami Shores Village.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Si s ULLI - - -- /
(Signed ).--
Date.. _ ... I_L/ 14/13 .
Capacity ^ eels
Street.....
's obligatio s
manent
employed 1
uch publ;
rformed
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
therein by him stated are true.
Notary Public, State of Florida
Plumbing Inspector
n ass
rum ment anti it
him I: •AI
notice
h 4 Ins . �Lril
n Plumber.
labor
ro b
+s ar
• br •
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclorowledgments, periorr; ; , ppear.c.
acts
NOTE: A re- inspection fee of ;1.00 will be made when such re- inspection is made necessary by improper notice fa inspection. 4tr faulty
materials and /or workmanship.