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.