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RC-07-623Inspection Worksheet Miami Shores Village `,F ��. 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 0410212007 Inspector: Grande, Claudio Owner: GILBERT, TERRY Job Address: 1480102 Street NE Miami Shores Village, FL 33138- CL Project: <NONE> Contractor: Buildina Department Comments Permit Type: Residential Construction Inspection Type: Re Occupancy Work Classification: Re- Occupancy Phone Number Parcel Number 1132050240260 Block: Lot: Thursday, March 29, 2007 Page 1 of 2 AM 03 Inspector Com is Passed 11 -12 305- 773 -1450 Failed El Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Thursday, March 29, 2007 Page 1 of 2 Bill To TERRY GILBERT 1480 NE 102 ST MIAMI SHORES, FL 33138 -2622 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: RC-3 -07 -27991 Invoice Date: March 29, 2007 Permit Number: RC-3 -07-623 Date Fee Name Fee Type Fee Amount 03/29/2007 Re- Occupancy Fee Fixed $60.00 03/29/2007 Re- Occupancy CCF Fee Fixed $0.60 Total Fees Due: $60.60 Payments Date Pay Type Check Number Amount Paid Change 03/29/2007 Check 2765 $60.60 $0.00 Total Paid: $60.60 Total Due: $0.00 Thursday, March 29, 2007 Miami Shores Village Building Department 11 �jj RE- OCCUPANCy-� MAR 2 9 2007 APPLICATION `= Y.° -------- - Date - Lo 7 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. ecnl —(02's i1 i1 Contact Name � e /C ��� Phone %�2 Buyer Seller Realtor Company Name Property Address / City Miami Shores State F1 Zip .33,,<3 a' I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant NameXG�° Signature The foregoing instrument was acknowledged before me this Z day of A�, 20 el by ��G� /j���who ' personally kno me or who has produced as identification and who did take an oath. NOTARY PUBLIC: �g,A ° COMMIM�N � DD 41521 EXPIRES: Apra! 12, M W stn,u$,Aa Us Sign: Re -Occ. $60.00 Print: Notary $5.00 My Commission Expires: $;eliz -% CCF $0.60 Total Building Officials Approval: (Rev. 10/02/03) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.... Z Date... 1 ...... ...................... Application is hereby or �e approval of the detailed statement of the plans and specifications, herewith submitted for the building or other application structure herein descriZed cation is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the La of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Villages be complied with, whether herein specified or not. A copy of * approved plans and specifications must be kept at building during progress of worky-1 .. ' / 6 z_- s;4' Owner's Name and Add . .. .. .. .. .. .......... ........ . ... . ..... Stree . ..... . ... . ....................................... Registered Architect and/or Engineer- . . ....................... --- ............ ......... ? a� I, Employing Electrician 's N e ..... ...... No ..... ........ . ... . .... . .... Street­ Location and Legal Description Lot ....... . .... -7 .. . ...... ............................... .........Block..:. ....... - - - - -_ ................Subdivision.... .......................... . ........... Street and Number where wi, A is to be performed—No ................................................ . .... . ...... »..... . Street ........ . ........... . ..................... . ..................... State work to be performed and purpose of building (By Fl oors)........_ ..............»........... ........... ............................ ........... ........................................ NewBuilding. . ........ . ......... . ... . .. Remodeling ............................... Addition .............................. Repaim ............................... . .... No. of Stories.................... Service n rgroun Size Feeders.. 7? ... . ..... Conduit; .......... Main Sw LA.2 .... . .... Als../. A ............ Main PuseL .... L »......... Amps 't Type of 15napin---Cony ult. .......... ..... . ...... Tubing . ...................... BXL ................ . ....... Meta ...................... ---- ------- I ---------------------------------- -- ------------------------------------ - - - - -- - ----------- I --------------------------------------- ... ..... . . ....»...»......... ...................... ................................................ T! .... ......... .. ....... ... . Amountof Permit 5........ ..... zk.'� ........ ....... »... »......r............ (Signed) .. tj ....... ............ ... ... . »....- - - - - -- Electrical 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 W4rkmen'a 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 subcontractors employed by him in the work to he performed u d t� 11 post or cause to be posted for inspection on the site of the work such public notice or notices T� permit; and will as are required by the undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are r licensed by Miami Shores illage. res 0 (Signed) ..... tlgo�� .............. Mader Electrician. STATE OF FLORIDA, COUNTY OF DADE. Before me, the and 'fined authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ftim"Pared --------------------------------- - ------ --------------------------------------------------------------------- ----------- - ---------- - - - ----------------- . .............. »...»............... to me well known, and wh�. being by me first duly sworn, upon oath deposes and says that he is the ................. . ........ . ...... . ... . .............................. of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him dated an ... . ...... .* ... . . . ....... . W. mmi;i;n.. 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 wo -ansinn 7 SWITCH LIGHT I PLUG �kCIVP'T'S FIXTURES REFRI IRON RANGE RANGE Wwrim W. HEAT. 9V STRIP TOTAL OUTLETS OUTLETS NO. LAMPS OUT6� OUTLET OUTLET CONN. HEATER CON". H HEATER ONTR. CLIST CHOCK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL OW. CAS. TEMP. PERM. .0.1 HP f, 1.5 HP TRANS. ONTR. CLIST CHECK Service n rgroun Size Feeders.. 7? ... . ..... Conduit; .......... Main Sw LA.2 .... . .... Als../. A ............ Main PuseL .... L »......... Amps 't Type of 15napin---Cony ult. .......... ..... . ...... Tubing . ...................... BXL ................ . ....... Meta ...................... ---- ------- I ---------------------------------- -- ------------------------------------ - - - - -- - ----------- I --------------------------------------- ... ..... . . ....»...»......... ...................... ................................................ T! .... ......... .. ....... ... . Amountof Permit 5........ ..... zk.'� ........ ....... »... »......r............ (Signed) .. tj ....... ............ ... ... . »....- - - - - -- Electrical 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 W4rkmen'a 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 subcontractors employed by him in the work to he performed u d t� 11 post or cause to be posted for inspection on the site of the work such public notice or notices T� permit; and will as are required by the undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are r licensed by Miami Shores illage. res 0 (Signed) ..... tlgo�� .............. Mader Electrician. STATE OF FLORIDA, COUNTY OF DADE. Before me, the and 'fined authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ftim"Pared --------------------------------- - ------ --------------------------------------------------------------------- ----------- - ---------- - - - ----------------- . .............. »...»............... to me well known, and wh�. being by me first duly sworn, upon oath deposes and says that he is the ................. . ........ . ...... . ... . .............................. of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him dated an ... . ...... .* ... . . . ....... . W. mmi;i;n.. 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 wo -ansinn 7 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No' -e 3J.j ....»............ Date :...... 2e.—c 1minx... 12.#....296.1 ........ 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 AddressM islMi ... shores ... Pa.Y.....F.amk... stay ...... AT!. ..................... ..Street. ..... No ... E------ 1-02nd St. Club, Registered Architect and /or Engineer.............. ..................... ................... » ............... .. ........»...-».. Employing Electrician's Name.Intersta.te ....E.lectric... Comoaallo.....644.. ». ... Stret.:N. - Ath Ave. ... ..... ...._........ � Locationand Legal Description Lot ..................................... ............................... Block........... ......................--- - -.... Subdivision ............... ............................... Street and Number where work is to be performed— No. »14 ®...1�1,,E e to lld, t e... »....... Street ...................»............. .......... »...........:........ State work to be performed and purpose of building (By Floors).......1i.15.....!11 ®® ampere.. service » »» NewBuilding ... ...... ... ......... . ....... Remodeling ............................... Addition .............................. Repairs. ..................................... No. .of Stories ..._................ Service Underground Size Feeders... ».. ».... »... :.Conduit ............. ..Main Sw ............ _ .......... ....Am .......Main Fuses ..... ... .... » ». ... .. .... Am s Type I Installation— Ctinduit ..... .................. Tubing ........................ B. X. L ......................... Metal Moulding.. . »..................... »......... I _ »... Amountof Permit $_....2,...2.Q .. . ...............».............. ............... »............... (Signed) The undersigned applicant for this building permit does hereby certify that he understands and, a is his obligations as an"tuiployer of labor under the Florida Workmen's Compensation Act, being Sectign 5966, Compiled General Lawn Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all eontraetors subcontractors employed by. bran in the work to be performed under this permit;. and will post or cause to be posted for inspection on th of the work such public notice or notices as are required by the Act, The undersigned agrees to employ only such subcontractors, on wo& to be performed under this penwta as are licensed by Miami Shores,, Village. � n (Signed).......! /4kW4$* Vii•. ..:. . c ......... ...... aster Electrician. OF FLORIDA, STATE � 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, and 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 Espfres » _ » » ... » .................. ».. .Notary 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. SWITCH LIGHT PLUO FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. g�ACB STRIP TOTAL OUTLETS OUTLETS RECE'P'T'S NO. LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. Harz HEATER CONTR. LIST - - - CHECK ENT. DIST. SERVICE, SERVICE MOTORS MOTORS NEON RAOlO. TOtA4 SW. CAB. TEMP, PERM. 0.1 HP 1.0 HP TRANS. Comm LIST CHECK Service Underground Size Feeders... ».. ».... »... :.Conduit ............. ..Main Sw ............ _ .......... ....Am .......Main Fuses ..... ... .... » ». ... .. .... Am s Type I Installation— Ctinduit ..... .................. Tubing ........................ B. X. L ......................... Metal Moulding.. . »..................... »......... I _ »... Amountof Permit $_....2,...2.Q .. . ...............».............. ............... »............... (Signed) The undersigned applicant for this building permit does hereby certify that he understands and, a is his obligations as an"tuiployer of labor under the Florida Workmen's Compensation Act, being Sectign 5966, Compiled General Lawn Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all eontraetors subcontractors employed by. bran in the work to be performed under this permit;. and will post or cause to be posted for inspection on th of the work such public notice or notices as are required by the Act, The undersigned agrees to employ only such subcontractors, on wo& to be performed under this penwta as are licensed by Miami Shores,, Village. � n (Signed).......! /4kW4$* Vii•. ..:. . c ......... ...... aster Electrician. OF FLORIDA, STATE � 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, and 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 Espfres » _ » » ... » .................. ».. .Notary 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DSPAPTMENT APPLICATION FOR BU'I6 DING PERMIT Application is hereby made for the approval of the detailed statvoyont u+ uie plans and specifications herewith submitted for the build inc 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,o(the State of Florida all ordinances of Miami S ores Village and all rules and regulations of the Auilding. Divbinn of Miami Shores Vill a shall be complied wish. whether herein sp ied or tic. A copy of approved plans and specifications must be kept at building during Viowess of the wo& d ecembeA ! 8! Date...........,... .....�.....w....»».�«..:.,..... , i� _ Owners Name and Address . V 4A.: ..i &Wa .. ..............».....«..«.»..... No.... 1480 .._». Street N. Lt. R. Registered Architect and /or Engineer...... r•�• . v •.,. •yn eswx�tww• .remna+.. ,.r .•...•.••. Ob'enouA%'o »o ' C'o. ! 1 / . " . i�'<Q!>u (,Z. Name and address of licensed contractor.......... »»..»......,.. _ -» _.. Location and legal description of kA to be built ont Lot........ .;.. Block .... y 02n � ...... . »1480 .....,.... . Street and Number where work is to be dons..,. .. ».... '�iemot,e ;t � � w r stark Otio andt, �,�. .............._.,...�.... •- ....._ ,..». Y ..� f r ... NW.....»•» _. »....................... iii» ...... _ ....... . ... ».. «... » ....................».�...« ............. - ». .»... .................... «........at (OF no ',6thw purpose. New $wilding .................... hemodahng . Addition. . ».. .. Repairs: To be'-constructed of .... ................. kind of fmrndatkNt.. »... . «..... _. treeing .. Estimated Total cost of improvements 8..... Q «c' D.LtQ.»... » »_»......dnai►nt of 'Pe�rmtt d►.» .. «_ . ...... Zone cubage required.. .. ..... «. Plan °Cubitge. ............. ...... ». _ Distance-to next nearest building ...................... » ..... ».... »..._Sitse '.of 8vilding `Lot.... ...... .» .......... - «....« Maximum live load'to be how by each near............ .. .................................... .............. ...................... 1 hereby submit all the O!ans:aod specifications for arid., adding, A#!1011011 with irefor""e .,to.,l building- and -its constivaion may be sent to.. ...... ............ ........ ... ....... The unrlersistned applilennt for this building pennit does hereby cert of 1.4hur under the Florida V4'aiknten a Con+ icnsation Act. baloo, Sectioi anti has compiled with the provisions tl>e i 'and will re4ulre i imilar c in the work to be performed under, . this permiq and will poat' fit souse 1, or notioes,as are required by tho Avt. The uador4itlned s rars'fco roaploy his ablitations as an I pulaw notice to under tills' permit as air licensed by W* Shmeri V1410S4. Reln.trl.5.. _ .................. . .. .............. »W�«.+.....,:,+.:.... ».., . « {.iigrldd r �� ^ "r"c. ". 4s�. si ka«.YLf .`•.�.:... »..r...:+....�.. STATE OF FLORIDA. 1 COUNTY OF DADE. j' Before me. the undersigned authority.'a ttotaty public. duly authorised to administer oftft.ar tait4 acknowledgn►atit;,'peesortally ap- peared ........ » ...r.... ,.....:J.:. .._ ...:.... ............. ............. _.. ._ ...._.» . r..r ...... ._ ...... . ...... ...... «. »..w.._.r...»..+........................ ... «•« � ..... .r,.+r.. —to Ine woo known. poses and who, being by me first duly mom, upon oath de and says that- is the:. .... ........ _ of the above described constrogUat, that ha! =hair carefully staad the foregoing s0plleath n, and that ire did sign the arse. tad that all fact: therein by him stated an ttious.. . Permit.. NOL» -2. bate. l���•L. «.... »... Red. two= to sled .SUbi�ilEd ttM. 'Disapproved .» ........� to ._. » ...».. ».....�...,.»..,... ................ ids .._»»........�..�.�. Notary Pttblie. Spats ofkr (Signed) ... -. - ' Building Inspector . ».•.» Mir CmniniisNon Expires.. ».....».......;,..:. PLANNING .....,.... »....,.,.- ..,,•,,.DATA; Chairman ...... .. ........ »..�..,...... ..»« ........«, .........,» ................... ..,..�..» »... Member ................... � ...,»...:,.` 1►tena� .. ....w. ».»...._ » ...........: - Member .. ...........» .. .... .«...»......,......,.._..... � Metnbsst ............» ......`.....,..». .... Council Approved .... .................................. ....,.».:.Bats ' 13s »,«...» ♦Dole NOT E: A ch.irge of 81.00 will be made for making corrections or changes to this applleatlon after approval has here obtained from die Board. A re- m,i,edion fee of $1.00 will be charged when stseh re- isupection hi mWo ttenebary by bnp opm notice for inapft -tMn or, fsulty materials andlor workmanship. Date d � Job / � Phi Owners / TenantB Owner's Address lii— C ZIT APPLICATION FbR MIAMI SHO S VILLAGE hj �'i I � �D - TaxFolio V} Ifistorieany Designated; Y No V S Permit # ®� yC% Phone OS-7.S (®` I � ci Contracting Co. 0"'� W, r,1 State # Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION Square Ft Address 4 SS# - Municipal # Competency # Address Address Phone Ins. Co. Address UILDING ELECTRICAL PLUMBING '. MECHANICAL Ri OFING PAVING FENCE SIGN Estimated Cost (value) 00 0, on WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT RESULT IN YOUR PAYIN G TWICE FOR MROVEMENTS TO YOUR PROPERTY (IF CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR Application is hereby ma to obtain a permit to do work and as indicated above, gu certify that all work will be performed to meet the standards of all laws regulating construction permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHAI, OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to d III Signature of owner and/or (tondo President Date Signature of Iftactor c III Notary as to Owner and/or My Commission Expires: FEES: PERMIT APPROVED: Mechanical -- _ President Date YOUR FAILURE TO DO SO MAY INTEND TO OBTAIN FINANCING, [CE OF COMMENCEMENT.) on the attached addendum (if applicable). I this jurisdiction. I understand that separate AL WORK. will be done in compliance with all applicable the work stated Owner - Builder Notary as to Contractor Owner- Builder My Commission Exp:r RADON C.C.F! NOTARY _ Budding 1 Elect: Plumbing - Er �I Date BOND y� TOTAL DUE "✓ ,� I' ] Date "I(9 Job Legal Description OwnerA"we / Tenant 1 Owners Address 44 f t Contracting Co. Qualifier State #��' Architeeffingineei Bonding Company Mortgagor Permit a eircie one TYP ( )• WORK DESCRIPTION _ n �I� p ZIT APPLICATION FOR MIAMI SHOR ign ME— t 0 ,QPlA !-�;,1 - Tax Folio Historically Designated: Y Masted (A 1NJ r Phone _ Address ACS i� _ Municipal # Competency # ELECTRICAL PLU a- 5 c^j Address A -SOIL- VILLAGE No ,aT Phone q 97— ® 0 6 -' Ins. Co. Stridesi7"f�1 FING PAVING FENCE SIGN (,-L ,'JELL) G(,110 EV CIN9 Square Ft. . Estimated Cost (value) of C " 00? WARNING TO OWNER: YOU MUST RECORD A NOTICE' OF COMMENCEMENT YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TRICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT wrM YOUR ER OR AN ATTORNEY BEFORE RE,CORI')ING YOUR I qOTICE 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 erformed 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;',ts accurate and that all work, be done in fiance with all applicable laws regl9atin 9 coqstruc4on and zoning. Furthermore, I authorize the above-named contractor to dc the Work stat �/7 Y } Signa a of o er and/or Cpndo President ate Signature of Contractor of, Owner -Buil ate 1 s ­4o t d/or ndo President .Date o to Contractor Own - uilder at 0 o Owner an r i , My Commission Expires My on Expires: g�1t x� 1Q3���a F GsL ��J LA�`ia'fl(tll'3L SC�4sa Q'�YY Z�U�d1.:c,.. J'�i �uE �`JL a r J DAY CGR-177MFUky EXIP. T-11 n FEES: PERMIT ®� RADON C.C.F. NOTARY TOTAL DUE Mechanical !. �'i( �` /7ldi Plumbing Engineering 9 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date / 0 /W/ ob Address Legal Description I Tax Folio/ _YA 'eAw ter Permit # -531 Owner / Lessee / Tenant elwveal �ii1�eiCT Owner's Address_ _ /�rfL) ij% /D Z ®IBC. Phone x�oxo /f��� Contracting Co. V'p�j,� �dyp/�yC Address /7/, Qualif ier State # SS# % Phone 0$7Z Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one) a BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Q�-7_ A0101 a',��T; Square Ft. ��d?}, Estimated Cost /02dT% 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. ►•• AP NEB ••a Ann inp P 6i0tlQ� • �, : JWSEPHWE CHURCH Signature � / $r an ; d g �� g V I � � X 30,1! oa C18755 OC197545 Date : + c N6tary/ as to Owner and /or Condo My Commission Expires: PERMIT FEE: 71,6 /I 15 ® APPROVED: Zoning President Nota r aafto Contr 1 e and number of . D, produced: My Commission Expire��S ❑ ID take an oath, or Fire OtheK ID NOT take an oath. Building 1 4 Electrical Mechanical Plumbing . Engineering I Village of Miami Shores N° 3324 10a ADDRESS / °� 6 c Al t . / ®z ° S 7° INSPECTION TIME READY REMARKS I I INSPECTOR — DATE 2 r I ����� �•• "e'yay cvD ia�;i a••1P NUM 3nw,4 ,ok At��l�iul•Ti OM130 i, .�' ..,: . -�. _�_.�,.. _. ....u.:. ��. _, .. ._ -.: r... l i - -:�.- �.. .«:. -� Yn.- �_.�....r r..�..�:i: ic....; ''�r .ia.�i. ::r...� ._, u. _': ��..t .�.:,%s.:.v,.. ... _......c va�•��:.z:: ., s.. .,_.... �........ -. ,..... MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 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. %pt. 29, 1971 Mr. Anderson- 1180. N. L. 102 St res Qwnor s Name at d Address --•- --_----- -----.- ---- -- _.. ....-- ........ No.:.. Reglamd Arehle and / ®r Engineer ...... ............. Orkin �Eut. Co.Inc..:� 1960 N.V.--ii Av Seia. eMet a..m..i .. ._ ..._ ........,.. Name and address of licensed contractor--_ _._........_..._ .. :._. Location and legal description of lot to be built on: __._._......... Block .. ... .............. .._...,,.._.._ Subdivision ....._- _- - -..__ _ ...._ Street and Number where work is to be done____. -_.._. State work to be done and purpose of building (by floors) WOUAnt FUTi. tion- likane 18 -24 hours ._and for no other purpose. New Building- _ ------ .. Remodeling- �..._._..._..... --__ Addition ------- Repairs :. .........._­ — No. of Stories.._._...._... To be constructed of-•--.---_---- __._...__.. Kind of foundation -- - _ --------- - - - -_ __.._._.___._._ Roof Covering_.._ . -- . Estimated Total cost of improvements $ ............... _._Amount of Permit Zone cubage required_- -. - - plan Cubage____ Distance to neat nearest building_- .- .__._.-- .___... -_ Size of Building Lot_.. _ ___ ...- .._ - -- Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent 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 employ�edd y 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 ublic notice _ or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performer ender this permit, as are licensed by Miami Shores Village. q, Remarks ( Signed) • STATE OF FLORIDA, COUNTY OF DADE. ` Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments," persgrtally ap- peared --- -... -- 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 be did sign the same, and that all facts therein by him stated are true. Permit No._ -_. Date_ ��� �_ Read, ;Sworn to and Subscribed before me. _ Disapproved Date y , Notary Public, State of Florida (Signed) _1L1L`- _ �Yl B g Inspector My Commission Expires.- PLANNING BOARD • --------- ___ -__ ...DATE Chairman ___ _._ _ -- — Member . �. ..._ Member _ _.— Member Member .......... Member 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. 3 /�' •�'•z %Zf �/C 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 Buihling.Divlsion of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spespecifications ficatios mast be kept at building during progress of work. Owner's Name and Address -- ,& L�P t � o�' / y/ � NO ®e_.. Registered Architect and /or Engineer FhPlaft Plt MW6 NAM ®.., Location and Legal Description Lec _----- Block -.-. —. , Street and Number where work is to be performed —No g State work to be performe8 and purpose of building (By Fhlore) New Bui1A -z Remodeling Addition_ _ .. _. Repairs..,..._............,. No. of Stories.. _ -_ -- Size Septic Tank Type of Tank _..._..._::opacity Gals..._. _.. _. Feet of Drain Tile *use Feet of Talc at Drain Field fcmn Well_ Nature of Water Supply: City —Well- - Size of Soakage Pit______...... Amount of Permit 8 -- d 7S The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliA�tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5W% Compiled Cenral Laws of Florida Permanent Supplement, and leas 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 pasted for inspection on the site of the work such public notice or notices as are required by die Act. The undersigned agrees to employ only sucb sub- contractors„ on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, O Master Plumber. COUNTY OF DADE. j Before me, the undersigned authority. anotary public, duly authorized to administer oaths and take acknowledgments, personally appeared tome 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 r"Fling application, and that he did sign the same, and that _ _ all fad- s therein by him stated are true. My Commission Expires Notary Public, State of Florida �w materials re-hapection fee w rlimansbzp. of 81.00 vviII be merle when seuh to inapeotiea is mEde•aeo�ery by Improper antics for inapectforb or faulty CLOSETS Tuns SHOWERS TORIES SINKS SLOP SINKS LAUNDRY URINALS CATCH FLOOR TOSS DRINKING TOTAL BASIN DRAIN POUNT-No FIXTURES CON K. LIST CHECK SEPTIC TANK - SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE' TRAP SOLAR DEEP SPRKLR. SWIM•O 77e.4 Al- %o.62 NEATER WELL SYSTEM POOL CONTR. LIST % / / IT CHECK ';?Aa'9 Size Septic Tank Type of Tank _..._..._::opacity Gals..._. _.. _. Feet of Drain Tile *use Feet of Talc at Drain Field fcmn Well_ Nature of Water Supply: City —Well- - Size of Soakage Pit______...... Amount of Permit 8 -- d 7S The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliA�tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5W% Compiled Cenral Laws of Florida Permanent Supplement, and leas 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 pasted for inspection on the site of the work such public notice or notices as are required by die Act. The undersigned agrees to employ only sucb sub- contractors„ on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, O Master Plumber. COUNTY OF DADE. j Before me, the undersigned authority. anotary public, duly authorized to administer oaths and take acknowledgments, personally appeared tome 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 r"Fling application, and that he did sign the same, and that _ _ all fad- s therein by him stated are true. My Commission Expires Notary Public, State of Florida �w materials re-hapection fee w rlimansbzp. of 81.00 vviII be merle when seuh to inapeotiea is mEde•aeo�ery by Improper antics for inapectforb or faulty MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Dat Time P `t A tom- 1 - TYPe Insp'� Permit No. Nam Address _ Company Sf 1 1 Phon For Inspector Name & D Approv Correction Re- Insp'n Fie O L,J� LP I� §.5T Ft#11 D I.P. SET I.P. &CAP �Ik� p P+��� 275 SET I.P. CAP LOT 9 i.P. LO 275 -: 4. V.p.V. 1.,1.a.. . . BLOCK -- SEr 0. CAP L8 275 otwo F r 0 10' 20' 46 6CV A . . SC ALE I RICH -- 20 BEET ter -� - • s A. R.!' TOUSSAINT & ASSOCIATES, INC. L AND SURVEYORS : I LOR40A, CERTIFICATE OF AUTHORIZATION NO. L8 -273 DAi 620 ,WE. 126 ST. NORTH MM, FLORIDA 33161 TEL (,M5) 01 -7340 fA= (30) 893-4M a , 11007 AFM 18� t9 S :..:. I� 1�2 P 52 sc" 1 �20' 95 t}RDEF» 142,80 511RV Y t1P1?/-W TO MW FB: 5$2 PG. 26 kikY 31. 2011 SKETCH TO SNOW RIGHT OF WAY EAST OF LOT 9 3, BLOCK 3 MAY 31. 2011 p LAT OF TRACT A OF MIAW SHORES BAY PARK 1 n ESTATES, FLAT BOOK 56, PAGE 86 14680 F" I OF 1 A& a hT IWX ASAFMT LOT BLOC Ole— I'iUNv I.P. su SET Lp 5 &w mm Lp. Rp SET I.P. dk CAP �1`P. 273 w..s 1 STY. SKETCH TO S14OW RIGHT OF WAY EAST OF - -- SET LP. Sc C : / •:: : LOT 9 , -BLOCK 3 LB 275 4UR&MC SCALE: 40 0 10' 20' 40' 60' 4 t .31✓ALL. 1 INCH = 20 FEET A. R. TOUSSAINT & ASSOCIATES, INC. LAND SURVF -YORS FLORIDA E:1= Rt1FlCM OF AUTHOMZA710M NO. L8 -273 DAl 620 WE 126 Sr. NORTH MIAMI. FLORIDA 33-161 M.: (30) 897 --7340 FAY- ) 893 -4)= :. : =: oRDM 17007 APRL 18. � � s 0M 1428A SUft V UP WE TO SHOW HIE OR RR: 552 PG. 26 MAY 31. 2011 10 MAY 31. 2011 FLAT OF TRACT A OF MIAM SHORES BAY PARK 1 p ESTATES, MAT BOOK 56, PACE gB 14080 1 1 OF 7 I WT as I MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 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 T'Onmg ein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, d all provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and dean and specifications' must asDivision t ivi kept at Shores shall be complied with, whether herein specified or not. A copy of approved p p g g progress of the work. ..._..._.. ........... 19... Owners Name and Address ....CW!Tn Y.,.90ilSt 'Coon CO. No. 1994._--- Street- -!Al ...1 th ..Ave • RegisteredArchitect and/or Engineer .. - -•- ............. _._ .......... -.._ ............. .............................. I-- ................... --- .................. - .............. _ Name and address of licensed contractor.. -Sheet Metal Sj3�C� - G.� -573 N.W. 71st .St._1._�i�ti - l�(�., Flat Location and legal description of lot to be built on: Lot ........ Block._•--- 3__.__• - -- Subdivision .._. ----- Mi-ani .Shores Ba Park Estates _--- - -._.. Street and Number whore work is to be done — ..__1480 N. E. 102nd Street State work to be done d purpose of building (by _ —_?boo ,ing..on -re _ria ®ice® ..... ...... __ _— ........ _ ... _....__..._._.__—._-_—__------- ...__._--------- _._...__.. ----- .- - - - - -- __ . — _ - - _ _ _ - -- - - - -- ._._...and for no other purpose. New Building __. -_-_- X ............... Remodeling ................ :......... Addition .......................... Repairs .......................... No. of Stories _.........one To be constructed of- .....CC.._.B•.'�5_ -- Kind of foundation .... _ ... .. .... ........................................... Roof Covering ....._tile _&...buil'�, 17.P Estimated Total cost of improvements $ ... _ ..... 9S � -©0 _... —_..- Amount of Permit $ ----- -- 5000 ---_-•--_....... . ............... _..................... Zone cubage required — ..______._ _._.__._ _ _ __.__.._.._— __ - - -Plan Cubage__--------..-_--._—__ -------- ____ _ ... ___ ......................... Distance to neat nearest building ....... ------- -----Size of Building Maximum live load to be home by each floor .... ..... ... .._........ I hereby submit allj the plans and specifications for said building. All notices with reference to the building and its construction may besent 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 Flo da Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida, Permanent Supplenient, and has complied with a provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be perfo' ed 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 requir d by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed y Miami Shores Village. Remarks �._.._ (Signed)___..�$T$TAL SPECIALTY CE3I�PAl�YY STATE OF FLORIDA, COUNTY OF DADE. 3S' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peered .............. _ —_. ,- ------- -._. -- me well known, and who, beang by me duly sworn, upon oath deposes and says that he is the .._ ....................... _._.................. .__._. ................ -- .._.._ of the above described iconstruct4on, 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. Permit No._ ____ ___ __.____.._ -. Date.__ _ _ _ -_... _ Read, Sworn to and Subscribed before me. Disapproved _ _ _ . __._- - -_ - -_ _ Date.._._ M_. ______. ___________ ------ _-._..._ .............. _ .... _-_— ___ ..... __ Notary Public, State of Florida (Signed) ---._--- -_- -- ---- -_-- _------ •- --- -_ -_- - -- ---- -- - - -- Building Inspector My Commission Expires---------------- - - - - -- PLANNING BOARD. __. -DATE Chairman Member Member ... _.. Council Am) Member ' _ --- ----------- - -_. Member Member 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. w i i r i i i 1 S or k m r � i fI� 1 WA 7- P W A Y } au. -oo Z1. !I h -M 00M 14f b aZ 88 !!5 ibJ k y,�, O - q U K ao u � � p► ,o✓ ,� f b'y VS f riJ .y f.. Ze F Lr:LTC!? C. o i.'V1,Y Lct °� L :?lock '�, iir.} Lt.l' tF` ...0 h�BAI P..iiiC E�ir.Cr , tt:ereoi as rECCrd c: in Fl t 3cok 5f�, l tbf acccrdir,6 to thf 11� -t � . t age of the Public Iteccrds of Dade County, Florin . Order tie . F.F. # 4f01- .38 bc4lcs shown I HLREBY CERTIFY: ThF t the attached "SKETCH CE 6U13VEY01 of the sbove af- scribed property is true ant; correct to the bE st cf my knowledge and belief as recent, ly surveyed anc: platted under pry direction. HARRI C. aC716LBIKE & A6.JCCL Ti-,., .INC. I . Albert j„ lcuswaint Registered Luiad ;urveycr #9,C7 States of F Grids. i i r i i i 1 S or k m r � i fI� 1