520 NE 102 St (2)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address 3 n � � / 0 2, /St • Tax Folio /1 #04? (1 /o6a 9.
Legal Description �C Iaster Permit # ��‘os
r / Lessee / Tenant I,J4 /Lk (S■✓ W J L, SO"
Owner's Address
Contracting Co.
Qualifier 0t'P/j/Q ,de"� SS# , phone 4 ` L: 76 i
State# go? Competency# 000 9/0/6,G Ins. Co. 'Mite/ astt4
Architect /Engineer Address �
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION t-{JJ'
Square Ft.
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. 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 state
Signature of Owner and /or Condo President
I e:/hay/. a
Notary as to Owner and /or Condo President
My Commission Expires: Ver4 ,- 6vf - //1
4I PU lJC STATEAF FLORIDAk
APPROV•
COMMISSION EXPIRES 5/09/94
4 o nded thru Stembler•Adams &Wet
PERMIT FEE:
,So
Zoning Building
Mechanical
phone
Address S T 70 /t.)' `-v (� �`
Estimated Cost Z .2--°
Signature of Contracto for Owner - Builder
Date: sI /a na
`Jiiiii
Notary as t Contr. ?' �s
My Commission Expir .c
* * *
Other
Electrical
SONDRA,JONES
•
@d1ns. Co.
CC173248
* * *
STATE OF FLORIDA - DEPARTMENT OF HEALTH ANU REHABILITATIVE 8EHVlt.ts
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM - CONSTRUCTION PERMIT
Building Permit 0:
& Chapter 10D -6, F.A.C. Application /Permit Number: el -/:5113
Date Application Received: f is /9
Fee Amount Paid: a • e- a
Authority: Chapter 381, F.S.
Application Is For: New System [ J Repair [1/r Receipt t: Jr/ ff1.e1/
Existing System [. ] Experimental System [ ]'
(Temporary) [ ] Tank Abandonment [ ]
Holding Tank [ ] Other (Specify)
NOTE: PERMITS EXPIRE ONE YEAR FROM DATE OF ISSUANCE AND ARE NOT RENEWABLE. REPAIR PERMITS
AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM DATE OF ISSUANCE. APPROVAL OF A SYSTEM DOES
NOT GUARANTEE SATISFACTORY PERFORMANCE FOR A SPECIFIC PERIOD OF TIME.
TO. BE COMPLETED BY AP APPIIICAPTi J
Owner: P1241 OA/ ��S Telephone: (Work) • (Home)75-e- E)S'O
o 1 2 Sf Cit M •.6 tats :R /1 Zip:
Owner's Mailing Address: L ��� 0 Y�
Owner's Agent: (1,) /J 1 LO Telephone (W) c..6 '2 7 ' ((H)
Agent's Mailing Address: 57q70 / ) •Q 4J 1 city: `l'Qrn/ State:/ ; P Zip:.. / LC
Property Street Address: ,k L N).' /
Exact Directions to Property: l !� L DCrC w as I / - J r' 4 4.1i
Lot 0 Block 0 Unit Date Subdivided
Section: Township:
Property Size: Square Feet /Acres
Public [te<Jimited Use [ ]
Water Supply: Private [ ]
•
Is Sanitary Sewer Available
Is Public Water Available:
Ranges
Type of
Establis 0 of Units
Commercial/ esident 1
(circle
Applicant'S Signature: ■..5.-;
PP 9
Parcel 0: Zoning Designation:
Yes [ ] No [ t(If $o, approximate the distance to the sewer
line closest to your property:
Yes [ ] No [ ] If No, approximate the distance to the water
line closest to your property:
BUILDING INFORMATION
Building 0 of Persons 0 of Seats Hours of
Area (sq„ft) Operation
& 0 of Bedrooms
Plumbing Fixtures: Garbage Grinders /Disposals _ Spas /Hot Tubs _ Floor /Equip. Drains _
Ultra -low Volume Flush Toilets Other
BUILDING PLANS MUST BE ATTACHED SHOWING OFFICES, BEDROOMS, TOTAL BUILDING 'AREA, AND ANY
PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, F.A.C. IN ADDITION, A DETAILED SITE PLAN AND /OR
SURVEY, DRAWN TO SCALE,' MUST BE ATTACHED SHOWING PROPERTY DIMENSIONS, BUILDING LOCATIONS,
AND PERTINENT FEATURES REQUIRED TO BE SUBMITTED PER CHAPTER 10D -6.046 F.A.C.
Date : . /n A
Permit No.___32
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot____
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
No..1
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subn{itted for l (he 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 pl,s and specification smyst be kept at
building during progress of work.
• Re 411 CS
Street_
Q Street__
Subdivision
Street
Street and Number where work is to be performed— No._kr_st e
State work to be performed and purpose of building (By Floors)___.
New Building S___ _ -- Remodeling____ _W_____ Addition._____ ........ Repairs No. of Stories. _ ...............
Size Septic Tank____
Feet of Drain Tile S
Nature of Water Supply:
Amount of Permit $_
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 5968, 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.
STATE OF FLORIDA, } ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Well
Type of Tank___ V B _
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
( Signed) _
(Sign
Plumb -Inspector.
Master Plumber.
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.
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 worbanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•N6
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
ONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
n -
... Ia Q IV- A L' AN ,
A a /I /f, /Y o
Permit No.___32
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot____
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
No..1
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subn{itted for l (he 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 pl,s and specification smyst be kept at
building during progress of work.
• Re 411 CS
Street_
Q Street__
Subdivision
Street
Street and Number where work is to be performed— No._kr_st e
State work to be performed and purpose of building (By Floors)___.
New Building S___ _ -- Remodeling____ _W_____ Addition._____ ........ Repairs No. of Stories. _ ...............
Size Septic Tank____
Feet of Drain Tile S
Nature of Water Supply:
Amount of Permit $_
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 5968, 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.
STATE OF FLORIDA, } ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Well
Type of Tank___ V B _
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
( Signed) _
(Sign
Plumb -Inspector.
Master Plumber.
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.
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 worbanship.