5 NE 102 St (2)MIAMI z 1 �4 VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui rring Inspection Request
Date +1
v1
Type Insp'n M 1,i no
1.-4Co4 — 15 3
U G C t_ ``
Address 5 NiE 1 vim- s
Compan 1 1+
Phone # JB tAO nc
Permit No.
Name
Inspection Date
Approved
Correction
Re- Insp'n Fee
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Roofing
Owner's Name (Fee Simple Titleholder) lobe Phone # 3b5 1 g Lk) Li 2
Owner's Address 5 [\Vt, 1 02. S+
City ►„ 11 DrC' i Sr 1 CS State 1 — Zip 3313
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
$ Value of Work For this Permit 4
Type of Work: ❑Addition
Describe Work:
Total Fee Now Due $ ( 0 \ t I 0
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax:, (305) 756.8972
['Alteration
N 102
County Miami -Dade
NO
Contractor's Company Name P3 i4 fR Dr,-} ion S
Contractor's Address 31( 11u> — 7? rlV r 17 ,Cr
City (' -1 t 2vy- i State ' 'i
Qualifier neOlo,e \/Q 1)coctre's
❑New
nno neci
Permit No. 1 71 C 04
Master Permit No. 01
Phone #
Zip 1 3el?
Phone # C'305) q - Q 7 33
Zip 331/2
State Certificate or Registration No.CP( ) 5C.ol Ot Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
❑ Repair/Replace
RECEOVED
1 6 2084
❑ Demolition
****************************F
Submittal Fee $ Permit Fee $ l0 v CCF $ ) . A - o CO /CC
Notary $ Training/Education Fee $ l D Technology Fee $ , iJ
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before i • �ORGe s
day of , 20 _ , by day of 3 , 20 J by /1
9,1 '!' 9A41�� g
who is personally known to me or who has produced who . person k now me or who has produced ,$
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Prin'`>t:.
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY:
Chc 05/13/03
as identification and who did take an oath.
P aY p � o • ct NOTARY SEAL
• eG 1ECiELVAUADAREs
` COMMISSION NUMBER
CC981568
• 1 (4> EIIpI
±2,2004
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
d
Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2004 -153
Printed: 8/17/2004
Applicant: ROBERT
Owner: SAKZ
JOB ADDRESS: 5 NE 102
Contractor P & H ADDITIONS
Local Phone: 305 - 264 -8092
Parcel # 1132060131640
Mechanical Permit
SAKZ
ROBERT
ST
Page 1 of 1
Contractor's Address: 3100 N. W. 72 AVE. UNIT 129
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 13 & 14 LOT SIZE IRREGULAR OR
Fees: Description Amount
FEE2004 -8298 Building Fee $100.00
FEE2004 -8299 CCF $1.20
FEE2004 -8300 Training and Education Fee $0.40
FEE2004 -8301 Technology Fee $2.50
Total Fees: $104.10
Total Fees: $104.10
Total Receipts: $0.00
5 agaS
Permit Status: APPROVED Permit Expiration: 2/12/2005 Construction Value: $2,000.00
Work: INSTALL HEAT PUMP
AUG 18 PAID
Signed: (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 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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Date (q" 12 -9 3 Job Address (^ 0 2 - ct Tax Folio I -06- 013 -t 64o
Legal Description Loll' ( M t A m t Sho2eS' J eC. 1 P6 i o" l 0
Owner / .Lessee / Tenant gd ` t C ], 0 - ,- l_e s Master Permit #
Owner's Address 5 N l= I O2 a
Contracting Co. J O S e ` e 'e) V c C �^ Address 15;1 (12 G rlA W * St VioLtAyouta
Qualifier krN ^ ><Oe,k. - SS# Phone ( ^SOS^ `1 (off ^� k
State # CCO [�u '.ie ipal # Competency # Ins.Co. PleUlDAJ LietJEW,
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMB '• ROOFING PAVING / FENCE -1 SIGN
WORK DESCRIPTION On,4 004 E QJ 1( 1 S ec12. 3' /2h) ,3
Square Ft. Estimated Cost(value)
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.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
FEES: PERMIT 7160 RADON C.C.F. / NOTARY ,6 TOTAL DUE 0 7, 5 '5
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
S-i--
* * * * * * * * * * * * * * '
Fire Other
Zoning Building Electrical
Mechanical •bJ 1Y gumbink Engineering
Signatu
Date:/
tar! as to Con
y Commission Ex
Phone
Contractor or Owner- Builder
4110 ' r4r. JOSEPHINE CHURCH
Wo any Publicjtetr flunde
OtM VMMERRVI $M40,1996
del No. CC1915t5
•
7 MtWRWt 1 fM / CY l! v�- y[:i.0 - >MdYF c^_
• ..
• :a-
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
PERMIT
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
CO r-r
Lot
N° 7898
Work to be performed under this Permit LA.) 41r—"' 4.*+r., A 1
2.
Bl
,� Value of I Amount of
k . t:r ,� Project $ rail I Permit $
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 applica-
tion 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 t he assumes respon-
sibility for work done by his agents, servants or employees.
r1*
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance th all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper au o ties of Miami Shores Village. In as
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
Signed.
BY
1
r
DATE
Contractor's
License No.
140 e 3 10 4 WA /CA.- 161"
Soto Z.
4690,4,. (..o.
Subdi-
vision
AUTHORITY
A
ABBOT `s'
Registered Architect and /or Engineer
STATE OF FLORIDA,
COUNTY OF DADE. j
Permit No '7 1 V Date
Disapproved Date
(Signed)
Building Inspect
2� G
MIAMI SHO {{ E VILLAGE
BUILDING INSPECTIQN DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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.
Owner's Name and Address___'C11t E T9 N __. No 5
Name and address of licensed 2 4 S 0
Location and legal description of lot to be built on:
Lot___ Block Subdivision
Street and Number where work is to be done S f
45 111__._e 111.2
Date 2/2g ,
street_ ICE— 1 62. 31
State work to be done and purpose of building (by floors)._ _D U T W 1, ( '__ ��_______ 4t1 _ JT E
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $ a_artT
Zone cubage required __________Plan Cubage
Distance to next nearest building ___ ___Size of Building Lot
Maximum 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 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 Sup lenient,
and has complied with the provisions thereo , and will require similar compliance from all contractors or : b- contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted nspection on the ite of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only suc sub ontraiors, " ork to be performed under this
Remarks (Signed) 40 I permit, as are licensed by Miami Shores Village.
10
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
NNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.