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500 NE 102 St (10)Date PERMIT APPLICATION FOR MUNICIPALITIES (OWNER TO RETAIN COPY) ,15 -m® Job Address S'70.0 N & / 2 Tax Descriatdon / /. /a qij 6Au fl11 m q Master Legal Owner / Lessee /. Tenant j4s4.e2 S t Owner's Addresj Contracting Co. I-I. � ,aa -P4 Qualifier COD Ne /IDZ Permit Type (circle one): LBUILDING ELECTRICAL WORK DESCRIPTION :o ary s o Owner and /or Condo President iy Commission Expires Notary Public, State of Florida at Lar k * . * idy Commission Expires *n. 21, 19* Bonded thru Agent's Notary Brokerage Ire 'ERMIT FEE: APPROVED: rF Zoning Building Mechanical umbing L/ M Phone Address / ''(«t( t.U) 2? SS# 7 L9 - 96 - Z( °t( Phone OF DADE COUNTY 6,21 F56 j State# . e7 - cr771 Competency# /WS h/ Ins. Co. 2: Lao_ Architect /Engineer Address Bonding Company Address Mortgagor Address ignatu O wner and/ .C ondo President Sig:ature o late: Date: Folio // gaa Permit 0 -/X.14/ MECHANICAL PAVING FENCE SIG2: Square Ft. Estimated Cost 2 '� Other 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. C ner- Builder otary a- to Contractor or Owner - Builder My Commiss ion Expires :NcterYPublic, State of Florida at Lar * * * *My Commi*i n Expired Jan. 21, 3 Bonded thru Agent's Notary Brokerage Electrical 9 /Engineering Chapter 100 -6, FAC S Date of Application STATE OF .FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Name of Owner. & ¢-S 51.,t_.?)AAJ Mailing Address of Owner cap P >✓ 1 0Z Owner's Agent r tor)pu e_U C, Builder Agent's Mailing Address ' {3C2 < < Iwo '1 f v A Telephone No Property Street Address v N C= 1 0 S-1 Lot No. Block No. Subdivision Date Subdivided NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION This Application is for: New System Repair v/ Existing System Type of Sewage Flow Sewage Flow Establishment (Gallons per day) Based On Type of Residential HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744. 001.4015-1) Authority: Chapter 381, FS ---- -- -PART 1 - APPLICATION Permit Application Number TOTAL FLOW = No. Bedrooms (each dwelling unit) AUDIT CONTROL NO N° 240905 Applicant's Signatur Telephone Number Heated or Cooled Area No. Dwelling Sewage Flow (each dwelling unit) Units (Gallons per day) ft2 ft Exact Directions to Property J Page 1 of 3 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA o PERMIT N° 7045 r�k 4„1 1.4.„ l i; Architect Contractor or Builder r' E' C- Legal Lot Description — � Bl Signed. ✓4 DATE `' ` 195 Contractor's r License No. Work to be performed under this Permit Subdi- vision Value of Project $ INSPECTOR Amount of Permit $ f 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 furthe -.condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowl ge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings?cr in the starents or specifications.and at he assumes responsibility for work done by his agents, servants or employees. ,� /" In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinaa 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 6 . 1r BUILDING ❑ DATE 3 195 1 ELECTRICAL. Pi PERMIT 'N° 11888 Contractor's PLUMBING License No ROOFING 1r Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Bl. Subdi- vision Value of Project $ Amt. of 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 application h`erefor 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. Signed• 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 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 reffonsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Permit No //RV MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date g• / 6 — 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. • C^ Owner's Name and Address /__�__ Sal) ) 4 /0 Z AAJ k No Registered Architect and /or Engineer Employing Plumber's Name_ _". -.k' Location and Legal Description Lot_________ Block o Subdivision Street and Number where work is to be performed —No. _ Street / State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs No. of Stories Size Septic Tank Type of Tank_ Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires .12,i' : -' . r _ No ( Signed) ( Signed) )s • Street Street Plurnbimgr 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 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 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 urder this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida STATE OF FLORIDA, 'e COUNTY OF DADE. 1 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. 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 SINKS LAUNDRY TUBS 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 7 } CHECK Permit No //RV MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date g• / 6 — 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. • C^ Owner's Name and Address /__�__ Sal) ) 4 /0 Z AAJ k No Registered Architect and /or Engineer Employing Plumber's Name_ _". -.k' Location and Legal Description Lot_________ Block o Subdivision Street and Number where work is to be performed —No. _ Street / State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs No. of Stories Size Septic Tank Type of Tank_ Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires .12,i' : -' . r _ No ( Signed) ( Signed) )s • Street Street Plurnbimgr 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 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 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 urder this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida STATE OF FLORIDA, 'e COUNTY OF DADE. 1 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. 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.