261 NE 102 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date lv - P S - 94 Job Address N_ E: •\ . Tax Folio
Legal Description
o _
Owner / Lessee / Tenant C\l -\ S 61 I S Q7 Master Permit # C / ( 1_3
Owner's Address c-U I I-4L 1,0 9_ Phone 1�. - a- � (0O x 383
Contracting Co. S Cf /I1 C- �=C c_ +- NC Address
Qualifier
a SS# Phone c-t. g -'q 0
State # Municipal # 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 0
Square Ft. Estimated Cost(value)
w
A
OFFICIAL NOTARY SEA
TRACEY C PEREZ
BLIC STATE
S
fPent
P• UNE 30,199
•
re of owner
Sign
Date
'otary as to Own
My Commission Expires:
APPROVED:
ALAI
or Condo President
FEES: PERMIT r" RADON
* * * * * * * *
/ooh
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 cone ructio an zoning. Furthermore, I
authoriz the above -named contr: tor to do the work state
ctor or Owner- Builder
OFFICIAL NOTARY SEAL
TRACEY G PEREZ
A
Notary a to Contrac r amawseanftitdamvA
My Commission Expire 'MYCOMMISSIONEXP. UNE 30,1997
C.C.F. r NOTARY TOTAL DUE 5
Fire Other
Zoning Building Electrical 14010
Mechanical Plumbing_ Engineering_
Olt
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WINO)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
—
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
—
SERVICE REPAIR/METER CHANGE
a • ._
�
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS -
RANGE TOP
OVEN
��'
—
•
PROCESS Alm PRESS PIPING
UIUERGROUIU TANKS
ABOVE GROUND TANKS
INTERCEPTOR
LAVATORY
LAUNDRY TRAY
WATER HEALER
MOTORS 0- 1 IP
u—
U.F. PRESSURE VESSELS
STEAM BOILERS
CLOTHES WASHER
SHOWER
MOTORS OVER 1- 3 IP
HOT WATER BOILERS
SINK, POT /3 COW.
MOTORS OVER 3- 5 IP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 IP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 IP
ELEVATORS /ESCALATORS
TEMPORARY WATER CLOSET
URINAL
=
MOTORS OVER 10- 25 1P
MOTORS OVER 25-100 IP
FIRE SPRINKLER SYSTEMS
COOLING TOWERS
WATER CLOSET
=
MOTORS OVER 100 IP
A/C WINDOW
-_
-
—
VIOLATION
REINSPECTION
INDIRECT WASTES
WATER SUPPLY TO:
AIR CONDITIONERS
-
—
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER- REPLACE
LAWN SPRINKLER -WELL
GENERATORS TRANSFORMERS
SPECIAL PURPOSE
-=
SWIMMING POOL
OUTLETS COM,CRCIAL .
�—
•
WATER SERVICE
SIGN TUBES
-
—
SEWER CONNECTIONS
SIGN TRANSFORMERS .
-
—
,
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS ,
DITAItNFIELD, 4" TILE/RES.
VIOLATION
-�
FUM'' & ABANDON SEPTIC TANK
REINSPECTI011 '
SOAKAGE PIT CU. FT.
CATCH TCH BASIN
=
De.
�
� —
-
—
DISCHARGE WELL
-
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
==
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
=-
GAS RANGE 41111
METER SET (GAS) " "11111
GAS PIPING • 41/
-�
ADDENDUM TO BUILDING PERMIT APPLICATION
• �
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEN•.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby ,ade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein descri ed. 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 .1t .
Registered Architect and /or Engineer
Employing Electrician's Name !' . 1 `� '`
Location and Legal Description Lot
Street and Number where work is to be performed —No r 1
No
4t ' /7 S treet
Block Subdivision
v
Date 41' ;
Street
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling s� Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ (Signed)
Electrical 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 complied 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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ,
�2 x -12 ( Signed).. C ° 2 -t
Master Electrician.
STATE OF FLORIDA, 4 !.(4 ' t- � u , . i
COUNTY OF DADS. )
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, and 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECC'P'T'8
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
e
Y,y
/ CIL,
Kip
/
/al"
/al"
�' (/ � '\ V
4
--
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby ,ade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein descri ed. 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 .1t .
Registered Architect and /or Engineer
Employing Electrician's Name !' . 1 `� '`
Location and Legal Description Lot
Street and Number where work is to be performed —No r 1
No
4t ' /7 S treet
Block Subdivision
v
Date 41' ;
Street
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling s� Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ (Signed)
Electrical 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 complied 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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ,
�2 x -12 ( Signed).. C ° 2 -t
Master Electrician.
STATE OF FLORIDA, 4 !.(4 ' t- � u , . i
COUNTY OF DADS. )
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, and 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.
BUILDING
ELECTRICAL
PLUMBING
Lot
CONTRACTOR OR BUILDER
PERMIT
ork to be performe
MIAMI SHORES VILLAGE, FLORIDA
DATE
N9 2570
udder this Permi
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building"
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 iti'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 s are changed without authorization. A further condition
BY
Subdi-
vision
Value of
Project
upon which this permit tics granted"rs` the understanding that the contractor or builder na ed a
the ordinances and regulations pertaining to the work covered, hereby whether shown o e,p
that he assumes responsibility for work done by his agent, servants or employees.
Contractor's
Lic se No
bve assumes the responsibility for a thorough knowledge of
np o ,dra or in the statements or specifications and
Signed: ...► y . , ,. 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 regula-
tions pertaining thereto and in strict conformity w th the plans drawings, statements or specifications submitted to the prop r authorities of Mi ores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employe
AUT " ORITY
19
2 6
BUILDING
ELECTRICAL
PLUMBING
4
The following is ready for Inspection:
Inspector's Report :
•
▪ WORK
• DONE BY:
•
•
• :REQUESTED
• -A'.
• •
• •
• : /,';
AD: . X/ =
Ole
WILL BE READY
‘,/
•
Permit
Amount of Permit $
STATE OF FLORIDA, I
COUNTY OF DADE. ss•
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL 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 Electrician's Name
Location and Legal Description Lot __ Block Subdivision_________
Street and Number where work is to be performed —No � i Street i ce' 4 w�______
State work to be performed and purpose of building (By 'Floors)
New Building Remodeling Addition .._______________________ Repairs
Street_________________ ___ _ _
Service Overhead Size Feeders Conduit._ Main Sw Amps. Main Fuses __Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding __ .___ _________-__________________._
(Signed)
4/
Date
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. / /
(Signed) ri"?
Notary Public. State of Florida
No. of Stories
0 Jr
lectrical Inspector.
Master Electrican.
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 be 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
W BR
EATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
•
Permit
Amount of Permit $
STATE OF FLORIDA, I
COUNTY OF DADE. ss•
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL 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 Electrician's Name
Location and Legal Description Lot __ Block Subdivision_________
Street and Number where work is to be performed —No � i Street i ce' 4 w�______
State work to be performed and purpose of building (By 'Floors)
New Building Remodeling Addition .._______________________ Repairs
Street_________________ ___ _ _
Service Overhead Size Feeders Conduit._ Main Sw Amps. Main Fuses __Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding __ .___ _________-__________________._
(Signed)
4/
Date
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. / /
(Signed) ri"?
Notary Public. State of Florida
No. of Stories
0 Jr
lectrical Inspector.
Master Electrican.
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 be 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.
building during progress of work. . 1
`tom
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name __________ ___
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
-ef
Date_
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
No.
No __ Street_
Location and Legal Description Lot_____ ____________— __________________ ___Block Subdivision________
� .
Street and Number where work is to be performed—No � Street ' s
State work to be performed and purpose of building (By Floors)
New Building Remodeling_________ Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit_ Main Sw.
Underground
Type of Installation— Conduit Tubing — B.X.L. Metal Moulding
Amount of Permit $
€70
licensed by Miami Shores Village.
STATE OF FLORIDA, I
COUNTY OF DADE. es.
(Signed)
Amps.
Street__
Main
s� I
(Signed) — –� \ iS . ai
My Commission Expires Notary Public. State of Florida
lectrical 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
Master Electrican.
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 be 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P'T'S
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
W R
ATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
building during progress of work. . 1
`tom
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name __________ ___
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
-ef
Date_
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
No.
No __ Street_
Location and Legal Description Lot_____ ____________— __________________ ___Block Subdivision________
� .
Street and Number where work is to be performed—No � Street ' s
State work to be performed and purpose of building (By Floors)
New Building Remodeling_________ Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit_ Main Sw.
Underground
Type of Installation— Conduit Tubing — B.X.L. Metal Moulding
Amount of Permit $
€70
licensed by Miami Shores Village.
STATE OF FLORIDA, I
COUNTY OF DADE. es.
(Signed)
Amps.
Street__
Main
s� I
(Signed) — –� \ iS . ai
My Commission Expires Notary Public. State of Florida
lectrical 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
Master Electrican.
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 be 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.