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560 NE 102 StPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) / ` Date , ? /J� /Job Address Q� 4 / /� . S / Tax oli i�C (19/7/'j� fL 0 Legal Description �j ,/ /./ 7z/ r 7 �� 4M �'Maaer er it ikY /f1 / Lessee / Tenant .3 /'j/ � _ /5 ce S D /2 P-- -3z73 Owner's Address -0/DZ _s �E>io- Address .!5: /1/ Z Phone 0^ Contracting Co. Qual if ie i State# Competency Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION My Commission Expires: * . * .* PERMIT FEE: APPROVED: Zoning Mechanical . , `et Square Ft. Estimated Cost 0 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. Address Address Address BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN Ins. Co. e of Owner , • vpraZ::: Signature of Contract Owner-Builder D t Signat a e . MY Cd'nSSiai EXP. FEB.2 .1493 INS. MD. hided Expires May 22 NNW 11iY1 , 199y _�' �„ � - „` rhFli 7..,r 1„ : ur a n , No ary as to Owner and /or Condo President tary as to Contractor or Owner - Builder My Commission Expires: * * * * * * * * Fire Building Plumbing _- Or-- Other Electrical Engineering 1 51, /Y & / D.2 SkYee k i4 on(' Sk0 %. 3313? - 5 ,O /V. & lO Si-ree,k hli4 wt; 5�o ✓ es �l4 3313? - 3 a 42 BUILDING ELECTRICAL PLUMBING Owner of Building v MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? Work to be erformed under this Permi '0' - V I ,,/ CONTRACTOR OR BUILDER </ • 5096 Subdi- vision BY )1 I Contractor' /.,(`"' License No / IN$ T O By In consideration of the issuance to me of this permit I agree to perform the work coverettereunder in compliance with all ordinances pertain thereto and in strict conformity with the plans, drawings, statements or specifica ns submitted to the proper author es of Mia In a this permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY 1941 Architect Contracto or Builder Legal Description Address of Value of Amt. o Building V U �` - � Project Pe '" This permit is granted to the contractor or builder amed above to construct the building or to install the equipment or device Aescribed 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 assures the re onsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or dings the stAaterne t `fur specifications and that he assumes respon- sibility for work done by his agents, servants or employees. gulations V„ialagel Permit No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 Architect and /or Engineer Employing Plumber's Name___,____ No.__ Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No._ __L___ % 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit of Permit $ - / - -- ( Signed) 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. STATE OF FLORIDA, t COUNTY OF DADE. ss. Capacity Gals. ( Signed) My Commission Expires Notary Public, State of Florida Master 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 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 DRINK NGI FOUNT'N5 TOTAL. FIXTURES CONTR. LIST �.-� I / ( i 72 - ' , - : , — j / CHECK 4 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 Architect and /or Engineer Employing Plumber's Name___,____ No.__ Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No._ __L___ % 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit of Permit $ - / - -- ( Signed) 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. STATE OF FLORIDA, t COUNTY OF DADE. ss. Capacity Gals. ( Signed) My Commission Expires Notary Public, State of Florida Master 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 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. Permit No ke\\\ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT ) A PPLICATION FOR PLUMBING 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 or nances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whet lf herein specified or not. A copy of approved plans and specifications must be k eSt' at building during progress of work. �_ r ` No '�` Street__ __ - ? L____ —�. Owner's Name and Address Registered Architect a or E ineer _________� Employing Plum er's Name .L_� a L .; r' r ' ', ' T . 7 " 6 Location and Legal Description Street and Number where work is to be performed— No Street / / ! ___w______r�` Feet of Drain Tile__ Amount of Permit $_ L ' ird My Commission Expires 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.___— ______ —__—__ Dist. Feet of Tank or Drain Field from Well ______ ___________________ ________ Nature of Water Supply: City—Wel Size of oakage Pit t _(Signed) Date_ (Signed, /�__ l ' '; Master Plumber. Notary Public. State of Florida Street 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. 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 under signed agrees to employ only such sub - contractor;, on work to licensed by Miami Shores Village. f Q j be performed under this permit, as are ,' � , f• . �, 4 .4 k. fs 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 – — -- — – – 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. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS $LOP 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. LIST CHECK Permit No ke\\\ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT ) A PPLICATION FOR PLUMBING 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 or nances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whet lf herein specified or not. A copy of approved plans and specifications must be k eSt' at building during progress of work. �_ r ` No '�` Street__ __ - ? L____ —�. Owner's Name and Address Registered Architect a or E ineer _________� Employing Plum er's Name .L_� a L .; r' r ' ', ' T . 7 " 6 Location and Legal Description Street and Number where work is to be performed— No Street / / ! ___w______r�` Feet of Drain Tile__ Amount of Permit $_ L ' ird My Commission Expires 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.___— ______ —__—__ Dist. Feet of Tank or Drain Field from Well ______ ___________________ ________ Nature of Water Supply: City—Wel Size of oakage Pit t _(Signed) Date_ (Signed, /�__ l ' '; Master Plumber. Notary Public. State of Florida Street 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. 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 under signed agrees to employ only such sub - contractor;, on work to licensed by Miami Shores Village. f Q j be performed under this permit, as are ,' � , f• . �, 4 .4 k. fs 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 – — -- — – – 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.