260 NE 102 St (9)** *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address CO ' "' A 2 Sr Tax Folio
Date
Legal Description
Owner / Lessee / Tenant
Owner's Address /WO
Contracting Co. //
Qualifierdl /(Ef j nAfir
��
co--4
State # r'X� 1 63 1 Municipal # 1 (6
:7_1//1-,04 S (4 W 421 `A/ 1 / 1 14 Master Permit # 3 �v 3
(5c41IIJ 7`Q 3sw( Phone ar r732/
F6PaRrG Address D--i1 S- /1/fs P V
SS# I - S C - 2 f l0 q Phone 76 ` 'S '
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 5rIPUk W c `I- P r1JEJ C /1"'t
Square Ft. Estimated Cost(value) /S-0-19
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
au .:i•.' ze the above -n . red contractor to do the work stated.
Signature
Date:
of owi►err and /or Condo President
Notary Public, State of Florida
My Commission Expires May 8, 1995
flaw_ /
aon d Th Tndo ro
Nota as to Owner' and /or o 14%giPdtitc-
My . remission Expires:
FEES: PERMIT 0 RADON C.C.F.
Competency # Ins.Co.
Signature of Contractor or Owner- Builder
Date:
i r.
,'
o _ e, eA14 XAk"A' • ' tAZZI
=''' COMMISSION NUMBER
Q CC360191
QU MY COMMISSION EXP.
CIF fV MAR. 29 19
. fi t
aka 6&
Notary as to Cont
My Commission Exp
NOTARY
APPROVED: Fire Other
Zoning Building
Mechanical Plumbing Engineering
Electrical ptp
TOTAL DUE 1 ( 6 4
la
l;••
plro ty-
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date l l 1S Job Address C-C:1 (L' /62 S T Tax Folio // JoS bi a
Legal Description
WORK DESCRIPTION
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
FEES: PERMIT
APPROVED: Fire
m S,Leri /
Owner / Lessee / Tenant � �� Master Permit # 3'/ d/
b
Owner's Address 57 8+1 4 I'til � � � � Phone �� C ?-?/
Contracting Co. N (M Q.Fc Address (S s T
Qualifier D /'W (EC r nl K SS# � - 3� - �1 Phone r. ) ) 0 ( OJT
State # ercr 3 I Municipal # Competency # 2 Ins.Co. SC04 t
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
ta
Square Ft. Estimated Cost(value) ) SC7
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.
ov
Signat p pff Contractor or Owner- Builder
Date: rldfiff
My Commission E
** * * * * * * * * * * * * * * * **
RADON C.C.F. • NOTARY i7 ; TOTAL DUE ,55'
Other
' `"
Zoning Building Electrical
Mechanical Engineering
APPLICATION FOR ELECTRICAL PERMIT
Permit No ‘1 Date 7". 14-7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv :ida,
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..., 4'Z / �! ." 4Z ( - -Q N E No 1 0 £ T _ Street
Registered Architect and /or Engineer
T /
Employing Electriciad's Name. }.M.P•b? /N No/ . Q... 76.. Ar W Street 63 .l f •• .d •
Location and Legal Description Lot / 0 Block Subdivision
6 Street and Number where work is to be performed —No 2 N G r.. f....41 - -2- Street
State work to be performed and purpose of building (By Floors)
New Building Reh+edefirrg... K I.S.T , Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
Underground Size Feeders Conduit Main Sw 1 ..0. /../.Amps Main Fuses . Amps
Type of Installation- -Conduit Tubing B.X.L Metal Moulding
Service Overhead
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit S (Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed).,, ...�.
STATE OF FLORIDA, (
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Electrica nspector.
ccepts his ob f ations as an employer of
of Florida 1 • ermanent Supplement, and
sub-contra ors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
Notary Public, State of Florida
Master Electrician.
and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made *hen such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T•S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.! HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
LIST
) I e
/
CHECK
APPLICATION FOR ELECTRICAL PERMIT
Permit No ‘1 Date 7". 14-7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv :ida,
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..., 4'Z / �! ." 4Z ( - -Q N E No 1 0 £ T _ Street
Registered Architect and /or Engineer
T /
Employing Electriciad's Name. }.M.P•b? /N No/ . Q... 76.. Ar W Street 63 .l f •• .d •
Location and Legal Description Lot / 0 Block Subdivision
6 Street and Number where work is to be performed —No 2 N G r.. f....41 - -2- Street
State work to be performed and purpose of building (By Floors)
New Building Reh+edefirrg... K I.S.T , Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
Underground Size Feeders Conduit Main Sw 1 ..0. /../.Amps Main Fuses . Amps
Type of Installation- -Conduit Tubing B.X.L Metal Moulding
Service Overhead
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit S (Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed).,, ...�.
STATE OF FLORIDA, (
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Electrica nspector.
ccepts his ob f ations as an employer of
of Florida 1 • ermanent Supplement, and
sub-contra ors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
Notary Public, State of Florida
Master Electrician.
and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made *hen such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.