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584 NE 102 St (3)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY � (OWNER TO RETAIN COPY) Job Address `� NE /02 Sig / Ml>'lri( .$ $• Legal Description 4 7r6,14e y (honer / Lessee / Tenant //4001/4 5 /7 LA-Cie-/\117-0-t- - Owner's Address Sf31/ NE (0Z f7 Contracting Co. COX INSURANCE REPAIR SVC. Address 390 W. 22ND ST. HIALEAH, FL. 33010 Qualifier CARL J. COOPER phone 887 -0315 State# CGC 001891 Competency /1 /'77, / Ins. Co. STATE FARM SEE ATTACHED Address Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION IN5U(2MN(I jP/q /2 Cf 4 C(f kj,q( i PA,70GL . Ca gr.L —75 - , reAl'Ley 74 — Square Ft. Estimated Cos q 3 9 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 Furthermor , I authorize the above -named contractor to 5.o he w•rk stated. ` 1 % 44 S!' ature of Date: s and /or Condo President to Owner and /or Condo ondo President My Commission Expires: / / /NV * * * * PERMIT FEE: APPROVED: __Lim, Zoning P I a i ii 75 I Mechanical N•` ary .s to Contractor or gwner- Builder M Commission Expires: 11/4 94 * * * * * Fire Plumbing Address Address Signature o''Contractor •r Owner - Builder Date: ' /I / iJ/ 4 Tax Folio // G� / `a/ 4 Master Permit # ' f 7 9,-- phone )57-6// p f/at':6C Other Electrical Engineering * zoning. * HOME OFFICE 390 WEST 22nd STREET HIALEAH. FLORIDA 33010 COX INSURANCE REPAIR SERVICE, INC. GENERAL CONTRACTORS- STATEWIDE LICENSED AND INSURED AFFADAVIT This is to authorize Pietro Giambroni to pull permit on behalf of contractor Carl J. Cooper. Carl J. Cooper SWORN TO and subscribes before me at Miami, Dade County Florida on this day of 19 NOTARY PUBLI DADE 887 -0315 FT. LAUDERDALE 522 -3966 BOCA 942 -3304 NOTARY PUBLIC STATE OR FLORIDA t4Y COMMISSION OP JULY,19,19y,3 BONDED THRU GENERAL INS. UND. PERMIT # Tax Folio No. // /7 16'L / ,< State of Florida County of Dade THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of the property, and street address if available) 584 N.E. 102 STREET, MIAMI SHORES, FL. 33138 2. General description of improvement: INSURANCE REPAIR OF KITCHEN CAUSED 3. Owner information: a. Name and. Address: ♦ • b. Interest in property: c. Name and address of fee simple titleholder(if other than owner): 4. Contractor: (name and address) COX INSURANCE REPAIR SERVICE, 5. Surety: a. Name and Address b. Amount of bond$ 6. Lender: (name and address) 7. Persons with the State of Florida designated by Owner upon . whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes:(name and address) 8. In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of re ,12444:6 NO00 N o t r y P u b l i c STATE OF FLORIDA COUNTY OF DADE 1 HEREBY CERTIFY that this is a t copy of floe oricincl file' in'thi office on day of WIT,C''25 my hand and Official Seal. 2 94 MS SEC 4 FOLIO #11 3206 17 1021 2 THOMAS J. LAUBENTHAL 584 N.E. 102 STREET, MIAMI SHORES ding unless a different date is spe ified) 0, e ' 3 90 W 2.2 s 3 3 01 V Sworn to and subscribed before me this day o D.C. NOTICE OF COMMENCEMENT BY WATER DAMAGE. 9 1 R 352025 1991 OCT 07 08:34 390 WEST 22ND STREET, HIALEAH, FL. 33010 ature , 1991. NOTARY PUBLIC. STATE OF FLORIDA MY COMMISSION EXPIRES APRIL 16. 1992 BONDED MU SIEMBIE&ADAMS & SWEET My Commission Expires;........ • OWtT°-R'S NAME ,...17 BL ILL, `,; ;. :.• PRESENT ADDRESS 584 N. E. 102nd Street LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 384 N. E. 102nd Street LOT ie`...a. BLOCK 9( SUBDIVISION ,4 •sh Q „PS GENERAL CONTRACTOR Owner ADDRESS 5 N. E. 102nd Street PHONE NO. LICENSE NO. BUILDING PERMIT NO. 10114 C DATE 10 /11 / 70 PERMIT FEE $ 6.00 BUILDER'S BOND NO. DATE ZONE REQUIREMENTS CU. FT. PLAN CUBE 2 6 1 V2 CU. FT. EST. COST $ 1, DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: JDH DATE 10/11/50 NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION REPAIRS DESCR IPTION ALTERATION DESCRIPTION Bedroom addition aid laundry X ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RESUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. I ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION lo/y0/5o JH FEE TEMPORARY SERVICE S BEAMS & LINTELS 11/6450 PG S $ SEWER FRAMING t(-14o P.~ S S GAS S S S $ FINAL DATE BY RE- INSPECT BY RE- INSPECT BY CLEAN -UP ROUGHING CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S S SEPTIC TANK S $ SEWER $ S SOLAR HEATER S S GAS S S S $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING ROUGHING GAS H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK SOLAR HEATER FIXTURES & FINAL FIXTURES CONTRACTOR S & H EIZC CO • PHONE PERMIT NO. 10 DATE 11•15 ■50 FEE $ 1.25 NEW BLDG. 1 ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S H. W. HEATER CONN. S RANGE CONN. $ MOTORS S FIXTURES S S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY BUflDING ELLC CAL IF` , PERM IT N° 10263 PLUMBING Architect Contractor or Builder Legal Descriition Addres of Buildin Owner Buildin of Lot MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit his permit is granted to the contractor or builder named above to coast uct the building or to install the equipment or device described in the application herefor n strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawin 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 t work is not done in compliance with such ordinances or if the Plans are changed viithout authorization. A further condition upon which this permit is granted :ts the understanding that the contractor or builder named above assumes the response ility for a thorough knowledge of the ordinances and regulations pertainin to the work covered hereby whether shown on the plans or drawings or in the state is of specifications and that he assumes responsibility for work done by s agents, servants or employees. Signed: 0y', INSPECTOR I consideration of the issuance to me of this permit I agree to per rm the work covered hereunder in compliance with all ordinances and regulations pertain thereto and in strict conformity with the plans, drawings, state is or specifications submitted to the proper authorities of Miami Shores Village. In accepting rmit I assume responsibfty for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY Bl. Subdi- vision Value of Project $ ISM DATE 195_ Contractor's License No Amt. of Permit $ < r • and who, being b of the above d therein by Permit No._ Disapproved 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 J5!_____• Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision__ Street and Number where work is to be done State wo be ne and purpose of building (by APPLICATION FOR BUILDING PERMIT f New Building Remodeling Addi ' A! Repairs To be constructed of Kind of foundation Estimated Total cost of improvements $ . 1 Z9_0 _Amo nt of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building g Lot____� 04 _Siz of Building � X Maximum live load to be borne by each floor 4J® MIAMI SHORES VILLAGE Date Date Building Inspector BUILDING INSPECTION DEPARTMENT cribed constru stated are true. Chairman Member Member Date No r- - �?1_ t PLANNING BOARD _L DATE Street No. of Stori _nt Read, Sworn to and Subscribed before me. (Signed) — =� d r . ,� ��qq 19 ��� Notary Public, State of Florida My Commission Expires Member Member Member and for no other purpose. r a_ W-- 1_ Roof Coverin f �s I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be serit 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 Supplement, and has complied 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, my sworn, upon oath deposes and says that he is the on, that he h arefully read the foregoing application, and that he did sign the same, and that all facts 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. B'1NG ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDe DATE 1/ 1950_ PERMIT r 0114 02 Pre 5 = to be perfor under this 'A Qui C A.1"4-".. Otoatav i'. Owner of Building Architect Contractor or B der Legal Lot ption Bu . , _ of Sgf Buil� g consideration of the issuance to thereto and in strict conformi g this permit I assumerespons OR BUILDER permit is granted to the contractor or builder named above herefor in strict compliance with all ordinances pertaining thereto and dra s, statements or specifications that may have been submitted to time if e work is not done in compliance with such ordinances or if t granted is the understanding that the contractor or builder named abo perfaini, to the work covered hereby whether shown on the plans o done s agents, servants or employees. ermit Subdi- vision BY AUTHORITY # icense Contractor s No g = )4 r otri.e.3 0 "4.%* C . lfr Signed: e of this permit I agree • perform the ith the plans, drawings tements or sp lily f y either, m yself, ployee. to �nstruct the building or to install the equipment or device described in the at lication wit the understanding that the work will be performed in compliance with any Mans, and appro d by the proper municipal authorities. This Permit may be revoked at any plans a changed without authorization. A further condition upon which this permit is he responsibility for a thorough knowledge of the ordi nces an regulations r in the statements or specification an t he assu e .on ty for work tires an . regulations Miami Shores Village.