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74 NE 111 St (4)10-- PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 14-00 Job Address 74- 77 • 7/1 Tax Folio WORK DESCRIPTION l// FEES: PERMITX Id RADON APPROVED: // Zoning Building Mechanical Plumbing No W � Owner/Lessee / Tenant /< 755 75 Z Contractin Co. L- A 3 3 C T g- PL_ LJ m 13 . Address d Co . x/E /30 5 T Qualifier DAVID 1Z- SS# 3 `13 State #C.- F G 011456 Municipal # / 3 S Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Legal Description Historically Designated: Yes Owner's Address _7 74 /VE C.C.F. (' gD NOTAR BOND Master Permit # Phone ,3 oS Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN E N O V A Tl 01`I / R Ep l v Square Ft. Estimated Cost (value) Z 4 b d 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 fpr 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 contra o do the ' rk stat 6. 1 I as Signature of owner and/or Condo President Date Signature of Contractor or Owger- 36/b y 1 //9 1 ) Notary as to Owner and/or Condo President Date Notary Contracto • r aT* a - ' 141 ,.7 My Commission Expires: My Co ssion Expir s: Y P 11C STATE O 9 ' Ndf COMMISSION NO. CC714103 MY COMMISSION EXP. MAR. 1 2 0 i T9TAL DUE /l� 64 3 e - O0 iSn o -0 a Date Electrical Structural Engineer ITEM BATHTUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE f BIDET LIT.UT OUTLETS CENTRAL HEATING DISITYNASTIER RECEPTACLES A/C (WIND) DISPOSAL SERVICE 1EhF'ORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR GRAIN SERVICE REPAIR/1kTER CHANGE REFRIGERATION GREASE MAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING 1 INTERCEPTOR RANGE TOP UNDERGROUND TANKS '• LAVATORY OVEN ABOVE E IUUND MKS LAUNURY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 IP STEAM BOILERS SHOWER MOTORS OVER 1- 3 111 HOT WATER BOILERS SINK, POT /3 COMP: MOTORS OVER 3- 5 ti' MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 81P TRANSPORTING ASSEM3LIES SINK, SLOP MOTORS OVER 8- 10 IP ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET 63JTORS OVER 10- 25 IP FIRE SPRINKLER SYSTEMS UR I UM. MOTORS OVER 25-100 IP COOLING TOWERS WATER CLOSET MOTORS OVER 100 IP VIOLATION INDIRECT WASTES A/C WINDOW REIASPECTION WATER SUFPLY TO: AIR CONDITIONERS A/C UITIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER-NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COhl€RCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY-WATER FIXTURES SEPTIC TAM( ANTENNA RELAY TELEVISION OUTLETS DRAIIIFIELD, 4" TILE/RES. VIOLATION FUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT (7J. FT. CATCH BASIN D I SOIARGE WELL _. t)OMEST IC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE P00L PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING J ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BET - OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 6/ Job Address NE III-She.+ Tax Folio Legal Description Historically Designated: Yes No iLessee / Tenant re-15 4 - A lu o4-+J Owner's Address 4 OE I l (5 �p fi f � CAM i ( IN ores R- I Contracting Co. Seq Qualifier State # Architect/Engineer Bonding Company Mortgagor APPROVED: Zoning Mechanical SS# Phone Municipal # Competency # Ins. Co. Address Ad Permit Type (circle one): 41 WORK DESCRIPTION Teat-r dcowr) �oQQs 44 c..c 1;41,t -rn Ia=n 7 Cssn Ir ac5 r (2A90; (c&f C r Square Ft. 0 c FEES: PERMIT cQ RADON ELECTRICAL Address Address MECHANICAL ROOFING PAVING FENCE SIGN 1 S'ru'v r k roa ba.4 Y2 � /r � � � 624-r pe.5 I n ©r,4 of to re-- i1)2 . Re -fi ■ le Estimated Cost (value) Z C7' 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. OWNERS 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 ' of Contractor or Owner - Builder Date Notary as to Owner and/or Condo President Date l Otary as to Cd4 rector or Owner - Builder My Commission Expires: My Commi'. on,Exp s: `FICIAL NOTARY SEAL F ° Q� s MARGAARITA 141V COVAI SSIONEPI OF F� DEC. 17,2002 C.C.F. °Ia NOTARY Master Permit # 3 31 6 1 Phone (7 ' BOND TOTAL DUE Date 3d - U Building ]9 Electrical Plumbing Structural Engineer BUILDING ELECTRICAL PLUMBING Owner of j f Building Architect Contractor or Builder Legal Description Address of Building CON Lot OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE RM1T N° 4633 Work to be performed under this Permit Col Bl. ./ — Value of Amt. of 7 /� iv 1" i 1/ 1. Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or devicidescribed in the appli- cation 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 upo whi is permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordi Inc s an regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assum r sibility 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 ordinances and regulations pertaining the o and in strict o ormity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In acceppnis permit i spon 'bi 'ty for all work done by either myself, my agent, servant or employee. Subdi- vision Signed • By INSPECTOR 7 Contractor's License No. /' �. BY AUTHORITY C ;WILDING -ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Lot Address of /,,, Building MIAMI `SHORES VILLAGE, FLORIDA DATE j / S 194e. Contractor's / U' S 7 License No. ERMIT N? 4633 Cor to be performed under r Bl. .e this Permit sibility foI work done by his agents, servants or employees. Signed. �( / 4 3 RAC OR OR BUILDER // /N BY Subdi- vision Value of Amt. of .. Project Permit This permit is granted t� the contractor orlbuilder named above to construct the building or to install the equipment or devie described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 asssujnes respon- B - i/1/'i)/ 1�/ INSPECTOR In co of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with 311 t1F finances and 9g ns pertaining t1 eto and in tri c l formity with the plans, drawings, statements or specifications submitted to the proper autho s of Miami Shores Viltage. In accepth thi pe +I res''' 't •r all work done by either myself, my agent, servant or employee. AUTHORITY • Permit No. E/ Amount of 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. Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE.- ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) No 79 Street_ Owner's Name and Address Registered Architect and /or Enginee Employing Plumber's Name , (�. ti__ -- No 74 - J_- J Street (/ Location and Legal Description Lot _Block Subdivision i - --, -' Date 7 g 1.1 tC-t My Commission Expires Notary Public, State of Florida Street and Number where work is to be performed —No r ! Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition ° Repairs No. of Stories p �/_ -_ C' Type of Tank 6_'f4 1. .4:: _ _Capacity Gals Size Septic Tank Feet of Drain Tile "ha Di t. Fee of Tank or Drain Field from Well 4 Size of Soakage Pit Plumbing 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) det er Plumber. 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 sane, 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 SWIM'G POOL CONTR. L / ` CHECK • Permit No. E/ Amount of 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. Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE.- ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) No 79 Street_ Owner's Name and Address Registered Architect and /or Enginee Employing Plumber's Name , (�. ti__ -- No 74 - J_- J Street (/ Location and Legal Description Lot _Block Subdivision i - --, -' Date 7 g 1.1 tC-t My Commission Expires Notary Public, State of Florida Street and Number where work is to be performed —No r ! Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition ° Repairs No. of Stories p �/_ -_ C' Type of Tank 6_'f4 1. .4:: _ _Capacity Gals Size Septic Tank Feet of Drain Tile "ha Di t. Fee of Tank or Drain Field from Well 4 Size of Soakage Pit Plumbing 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) det er Plumber. 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 sane, 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.