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Multiple (18)Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/15/2005 Applicant: MONISE Owner: MILLER JOB ADDRESS: 177 NE 103 Contractor BRINKS HOME SECURITY INC Local Phone: 305 - 887 -8455 Electrical Permit Permit Number: EL2005 -234 Page 1 of 1 GRAVES GILBERT ST Contractor's Address: 9960 N. W. 116TH WAY, SUITE 12 Parcel # 1121360130840 Legal Description: 36 52 41 3152 42 MIAMI SHORES SEC 5 PB 10-47 LOT 21 & 22 Fees: Description Amount FEE2005 -9467 Submittal Fee ($50.00) FEE2005 -9666 Building Fee $100.00 FEE2005 -9667 CCF $0.60 FEE2005 -9681 Training and Education Fee $0.20 FEE2005 -9682 Technology Fee $2.50 FEE2005 -9683 Scanning Fee $3.00 Total Fees: $56.30 Permit Status: APPROVED Permit Expiration: 118/2006 Construction Value: $700.00 Work: BUGLAR ALARM 1 MASTER 5 DEVICES Signed: (INSPECTOR) Total Fees: $56.30 Total Receipts: $0.00 JUL 2 2 PAID BLK 122 LOT Cl+c #� 5 4( =13 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami -Dade My Home -Text 1%. , My Home Show Me: Property Information -Text e Search By: Select Item. Address Search 'Enter the address and click "LOCATE ". Use the Tab key to switch between fields or click using the mouse. House 1 �� Number. - Direction: NE Street Name: Street Type: ST - -- Unit (opt): —� Zip Code I'i (opt): �_ - -� Page 1 of 2 n A,ci 7. Go to proper map ffiv' Print friendly version Summary Details: Folio No.: 11- 2136- 013 -0840 Property: 177 NE 103 ST Mailing Address: E GILBERT GRAVES JR &W MONISE Floors: 177 NE 103 ST MIAMI SHORES FL Living Units: 33138 -2328 Pronertv Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 4/3 Floors: 2 Living Units: 1 Adj Sq Footage: 2,771 Lot Size: 12,400 SQ FT Year Built 1946 Legal Description: 36 52 41 31 52 42 MIAMI SHORES SEC 5 PB 10-47 LOT 21 & 22 BLK 122 LOT SIZE 100.000 X 124 OR 20487 -0738 06 2002 1 Sale Information: Sale 0/R: 20487 -0738 Sale Date: 6/2002 1$338,000 Sale Amount $79,552 Assessment Information: Year. 2004 2003 Land Value: $119,328 $79,552 Building Value: $223,726 $219,015 Market Value: $343,054 $298,567 Assessed Value: $304,240 $298,567 Homestead Exemption: $25,000 $25,000 Total Exemptions: $25,000 $25,000 Taxable Value: $279,240 $273,567 %: We appreciate your feedback, please take a minute to complete our survey. My Home I Proper Information I Property _Taxes I My Neighborhood I Property Appraiser Home I Using Our Site I About I Phone Directory I Privacy I pisclaimer If you experience technical difficulties with the Property Information application, please click here to let us know. E -mail your comments, questions and suggestions to Webmaster Web Site O 2002 Miami -Dade County. CC http:// gisims2. co. miami- dade.R.uslmyhomelproptext. asp ?app — none &bytool = none &cmd =FI... 7/5/2005 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT (013 0 APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept all building during progress of the work. Date- - - - -- -7/29/6-4--------- Owner's Name and Address. AWOOD.. 1. T%--- KaEs._10_$' t_-- .... ... ......... ........... .- No.4- 7.2 --- . Street- /f3._ -3. a..________ -_ -__ RegisteredArchitect and/or Engineer. - - --- ----------------------------------- - --- --- -•- ............................ ---- ------------ .......... - .................. -...................................... Name and address of licensed contractor .._ - -- 1iaiCe_- Cp nJ9xAer...$ .eMic@._.C44� ---- - .. = _�,,t..&W ....6 .AYIR- ------ --- ------- --- - - ---- Location and legal description of lot to be built on: Lot-------------------------------- - - - - -- Block. --------------------------------- Subdivision --------------- - ---- --- - - - - -- - - - -- - - - - - - -- - -- - - Street and Number where work is to be done ._- •_ _________ ____ + �_1 __Sty _177 State work to be done and purpose of building (by floors) --- -- ---- .- JIMU11-- one.- -1_ -W _air - cpndItj.omer_•jQ__•__•_- ____ -_ - -- ----------- Ge8e1A @lfll�-- 6��.tbdOBY�.-- - - -- -• 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 $ ---- 2 ----_------------------ - ------------------------- - Zone cubage required --------------------------- ---------------- -- -------------- - - ---- Plan Cubage --------- - ------- ---------------- ------------- ------------- - - - - -- ................. Distance to next nearest building _--_--------------------------- --- -- ------ - -- -Size of Building Maximum live load to be borne by each floor ----------------------- ---- ___- __ ----------- -------- - ---- I hereby submit all the plans and specifications for said buildin . All no ices with refer nce to the building and its construction may be sent to mAianee ggps e r Serivice Co 123 S. t. 67 Aved 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 post d for inspection to of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only su subcontractors, work tis performed under this permit, as are licensed by Miami Shores Village. Remarks_ — _ ----------- _------ ____ -- -_- (Signed) STATE OF FLORIDA, COUNTY OF DADE. I ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- ------- •----- __. —^__ ------ ---- ______ _____-------- _____ -- _.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. Permit No. _ 67-0 Date ____'' /'_;_____________ Read, Sworn to and Subscribed before me. Disapproved-_- - - - •- - - -- Date_.----- _---- ---- ----- - - - - -- ---- --- - - - - -- -- - - - --- - -- ----- ---- - - ---- - - -- --- -- - -- - - - 41 Notary Public, State of Florida (Signed) ----- --- - - Building Inspe r I-�%k - My Commission Expires-- ------- -- --- - - --- -- PLANNING BOARD-- -__ - -_ Chairman --------------------- Member - Member- ------ ----------- ------------- - - - - -- -- - -- - -- Council Approved - _________ --- - ----- _ ------ ----- -_Date • -- -------------- - - ---- -DATE Member------------- ----- ------------ ---- - - - - -- -- --- - - - - --- Member---------------------------------------------•------------------ -- ---- _ --------------- - Member - -- -- -- ----- -- -------- ----- Disapproved-- -- ----- ------- --- -- -- - --- - - - - -- --- - - -- -- -------------------- NOTE: A charge of'1 $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. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY ( OWNER TO RETAIN ,C. OOPPY) Date G��p_ 9 /Job Address Tax Folio// Legal Description&J°/'�°o� J, ��( �r�✓�l Master Permit #�,✓ /� Owner / Lessee / Tenant %,�� O142 P/ _ Owner's Address /,�/� G1/i - Q� �7, Phone Contracting Co.�I��i � ®��'fi�� qy� Address �� ® �� ✓. �'�%s� • Qualifier SSA Phone 0_1�3 S—.17 S-7- Stated Competency¢ �y��/�/P, Ins. Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): WORK DESCRIPTION BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN _j�o, Square Ft . ,� ®C� od Estimated Cost 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 lava regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLDMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVITA AFFIDAVIT I certify that all the foregoing information is accurate and that all work will be don i com i ce with all applicable laws regulating construction and zoning. Furthermore, ize t e above -named contractor to 'do the work stated. Signatures 01 Odder Date: \ ary as to Owner and/ Commission Expires:-7' r or C ndo President ignature of Contractor or Owner- Builder Dater FEE: APPROVED: Conte President Notary as to Contractor or Ownj!tc- Ba91✓. } My Commission Expires: Fire Other4 ( - - Zoning Building Electrical Mechanical Plumbing Engineering 918141696 State of Florida County of Dade lax Folio No. �// - r✓i -� i -, v NOTICE OF COMMENCEMENT 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) - 177 N.E. 103 STREET, MIAMI, FL 33138 2. General description of improvement: New Tile Roof ------------------------------------------------ ----------------------- - - -- 3. Owner information: a. Name and. Address: NESTOR NAVAS 177 N.E. 103 ST. Miami, F1 33138 b. Interest in property: Owner c. Name and address of fee simple titleholder(if other than owner): 4. Contractor: (name and address) MIAMI ROOFING& INSULATION CORP. 5. Surety: a. Name and Address ----------------------------------------------------------------------- b. Amount of bond$ ----- - -- - --- b . 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)7.0 Florida Statutes: (name and address) --------------------- ------ -------- -----�__ 9. 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 exp}rati §njdate is 1 year from the date of recording unless a different date is Sworn to and subscribed before Notary Public Signaturli o this 37&4 day of � /_off './ 1, 1991. }�� ('r e� ..��` � ^Y ffK yyilii::i, l�`�RTT.• Pr ��A �ao:.� . .. .... ....... �e�, _.. ,r, r•. :_fit My Commission Expires: STATE OF FLORIDA COUNTY OF DADE I HEREBY CERTIFY that this Is a true copy of the original filed-in this office on 15t of M AY , A.D. 19 LL-_ WITNESS my hand and Official Seat. M F A: �^Q/z - - I J0 I .. rs+.. �.'-. w+-'.. w' �L+.. �aw��► wW,•., wn+ +rw".wra+�;r+a�1s�'.+.r.�ya r�+w�• ��±'..+w...r�.e�hr`.tr.'�rfrn - '+` � � � "" s �"" « ... - .r,.>:.►..w,r+.•.. •i�rlr,./,y.~ r- .•.-.: - .hr.r.r w.* t •- ....T .:� r �..... -r!rM' � r. ` ` � r ' ' � ; [- � f ";J, © ©/ �t �.JS� � ✓�i'� r.'.�� .. �� i s { 'F r• 1t ♦ k t w. 'v i �' �� - � ��+ � t �,Irwn.....� �r+'v.v.rOr. w.,rnr ��'.. �, `�' „ .. e��*•w +!^' i • � � .",± r ! K.} � _. rl. j i orz- A ICA 16 4"e .•T r,.. ..-w .�� ,.i.�M��..a ..4�rMr'""u'w.1'i�.y�!, �`,.� 1 i+ i _ � X , t ty♦ 'r n; � 1 w APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY L hereby apply for a certificate to re- occupy the single family residence ;mown as: (address) 1-1-7 N I S) 3,1--t S—, fi \Miami Shores, Florida. Legal Description: Lot: Block PB & PG: I hereby certify that I understand that the zoning of the property is for single-fianily residential use and that it is unlawful for more than or..- y 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 ssgle- 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 such property. Applicarnr✓- ^^---- ' Date �i 2 i°� V Print Name �� y cSS For purposes of conducting the inspecz:on required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact Contact Name: T, c S S Telephone: L3 6,0 `7 S:-9 — 9 4 S Z Buyer Seller Realtor Application Fee (S50) paid: Cash Company Name Check No. ( 2 L�44 )? /,p 0 Inspected by: F. LUBIEN A'p -ed X Denied Date 8/28/99 Comments: ?AGF I C- - CERTIFICATE OF RE-OCCUPANCY On behalf of Nfiiami Shores Village, Florida, the undersigned certifies that the property described in the above application has bee inspected for purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Scores Land Development and Zoning Code and that such property may be re- occupied by the above applicant for single - fancily residential purposes. Date of Certification: 9/ 2 8/ 9 9 THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN Ii TSPECTED BY NQAM[ SHORES VILLAGE AND HAS BEEN MNM4M TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE NE AIVII SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE -FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY, HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF T E PREMISES sN ORDER TO DETU34INE THE CONDITION, ,I REOF. PAGE 2 OF 2 MIAMI SHORES VILLA13E BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the Wroyal 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 pt9gress; of the work. Date. d ay --------- .19 w Owners Name and Address ...... J ID % Registered Architect and/or Engineeer ...... ................. .............. .... »_......,.................,.. 0 6S.0 IA44 Name and aa&m of licensed controctor.10-sk.4"404, 9 LLot .a.t.i.o..n .�4 .l.e.. g. al d.e1sR .ion . Bf ook .t. o . .b..e .. . I b. u.2 .. i l..t . .Q. Street and Number where work is to be done._. a Vrk to be done and p�� of building (by &1-.4 A i , ,11,_,,... a New Building .............. ............... Remodeling ... . ............ ...... - Addition... /R.-I It Llb'0_1 &t--. 1— Ulf &. l®— J�Lkx - ---------- L41.. Iraq aw .4 and for no other purpose. ............ Repairs...._................... No. of Stories ...... Z ...... »...._ To be constructed of ............................ Kind of foundation......._............. ............ ........... — Roof Covering._.............. Estimated Total cost of improvements $..._....,[ ..............Amount of ""..'t Zone cubage required._ ................ ........ ........ Distance to next 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 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 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 ---- — -------_----- _7 ...... . (Signed 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, and who, being by me first duly sworn, upon oath deposes and says that he is the . ........................... . .................... ... . . . . ............. . ... ...... e 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 axe jrue. . Permit No. 2" 7/ . . ...... Date....! 2- y Read, Sworn to and Subscribed before me. Disapproved....... ........... . ............................... . . . . . . 17' Notary Public, State of Florida (Signed) ....... .... . .... . Building nspector My Commission Expires.. _... »» P ING BOARD . . . ...... .................._ »....._....» —DATE Chairman .......... ........ . ......... Member Member . ..... Member Member .. ... .. ........... Member Council Approved. ------______.__..._ ---Date Disapproved ---.-. w_..».......... »............... . 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 Plannir,_ 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 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 compliQ with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during pNgress of the work. p� Date. /Z — . ,19 Owners Name - and Address.. � ... .....� 1%� ................ ». No...1 -7-2 ......_.. Registered Architect and /or Engitlm ...... ....... ,..... .........»...._.. ».._........ ........ .......................... Name acid address of licensed contactor.....:._.. j�....... tf........ _._...1�....�»�5 :. »v�'��s.. Location and legal description of lot to be built on: Lot .............. ................ .. . .. Block .. .................. » » .... ».» Subdivision._... »...... » ... ». ».......... ..»........ ....... .._.......... Street and Number where work is to be done.. xZ _��. s... ».... _..» ». _........ State work to be done and purpose of building (by floors) R;a;a..:F._..: '73 ........ _.....» ..._....»»..» — .._and for no other purpose. New Building .............................. Remodeling ..... _.......... .... Addition .......................... Repaid.. .:. No. of Stories._) To be constructed of.. .......................... land of foundation ...._._...... � W^- -- �........... ......._......... »-- »-- ........ Roof Covatrtg-- ...... RICA_ Total cost of imiprovements $... .. »_ _.....amount of Permit $� ... »._.. .� t. �. �' Zone cubage required ........... ...... ........ ... ..... _ ... ._....._ - -. _.. -plan Cubage-...._........... » ...... . Distance to next 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 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 Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied wjth 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 em M e ploy only such B�lyd/')� under this permit, as are licensed by Miami Shores Village. /A.17 ..- ....... _ ._ . ( Signed k'a,.. `:-t-' 1- 0410-1, 4 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, 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. Permit No. _._i �tel _ 9 6'_ _. ...... Date... -,/ / 7 y Read, Sworn to and Subscribed before me. Disapproved .Date._... _. .... _ ........... _ ...... .. ........... _ .... _ .... ... ......._.... Notary Public, State of Florida ( Signed) ._ ....i .......,, 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 Plannin;,, Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inRw -titm or faulty materials and /or workmanship. r2 .................. I MIAMI SHORES VI LLAG E 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. Owner's Name and Address A& ® -i — No. 7 7 Street -L&__ ,e�- Registered Architect and /or Name and address of license Location and legal descriiptioi Street and Number where work is to be done e State work to be dome nd purpose of building (by floors and for no other purpose. New Building Remodeling Addition Repairs____ —_ No. of Stories __ To be constructed of _ Sind of foundation Roof Estimated Total Total cost of improvements $— oa—Ir., _Amount of Permit Zone cubage required plan Cubage Distance to next near building Size of Building Lot— Maximum live load toe 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 has ate employer of labor under the Florida Workmen's Com ensation Act, being Section 5988, Compiled General Laws of Florida, Permanetit Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employe�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 subcontr rs, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) STATE OF FLORIDA,, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally ap- peared 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 regoing 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 I L14. Al Date (Signed) Notary Public, State of Florida Building 19vector A My Commission Expires Chairman Member . Member . BOARD __ _DATE Member Member Member Council Approved Date Disapproved 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- �'ns�pectfon 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 VILLA13E BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uiade for the approval of the detailed statesslent or one 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 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 piotgress of the work. Date Ownei s Dame and Address Registered Architect and /or Engineer.... . ................. ...................... .............. ....................... „.... Name and address of licensed contr clot... ZA .. .. ............. _ ..... .._»».._.. Location and legal description of lot to be built on: Ill Lot....... L ... ...� „......... Block. „........t.. ��.. ....... i Subdivision.. .. t& �i t}t $ ... �jo Street and Number where work is to be done ...» ............. »._ „_ � »......_... ___ .... „. „......._..... State work to be done and purpose of building (by floors), ...»».._. „ .... _. _.. „............ „:.„ . ...... ... ._.... ....... _....L-.%�.:�e:l_.._..� ®.0 for no other purpose. New Buil ding ............................. Remodeling ........................ Addition ...... „.................. Repairs... .................. No. of Stories ...... .._ ... ... ...... _ To-be constructed of ......................... Kind of foundation:...„.„--.__. ............................... _ ........... Roof Covering ....................... ........... ... _...._ Estimated Total cost of improvements 5........:x.4 s » »9 .....Amount of Permit ?..® A...„.......„.„„ .. ........................ „_ „ „... Zone cubage required ...... .................................... ......._._ _. „„„„. —_ „..Plan Cubage ................... .....„....._....„.........._.._ „. „....._ ................ _. „... Distance-to next nearest building ................................... ...... .... „._._._. „Size of Building Lot ....... .„_ „ „......_.. „._ ................ ........................... Maximumlive 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 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 Florida Work-men's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup pleutent, and has complied with the irovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be perforncA 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 subcontr ct oa It to be performed under this permit, as are licensed by Miami Shores Village. Remarks...................... _......... ... „......... „ „ „. „...„........„ (Signed).... „ STATE OF FLOTIDA COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. persortally 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 lie 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. DisapprovedDate. _. . _.„„ .. „..... „...... .... Notary Public. State of Florida ( Signed) ... » ....... ..„ ................... .. .............. „ „ .......... _.. Building Inspector My Commission Expires..._. ... PLANNING BOARD ..-...._...... ...... ............. __,.._.„... _DATE Chairman ...... .. ........ ... ......... _.._....._ ........ .._ . _ ....„ _............ Member ......._.. ........ „ .... .»„_._ ..._....».».................._. „......„„ . „„..._ .Mery ber ....... __ „_ ...................... „.. „..._. „„„. _„. Member _ ..._._..... »» „._...... . _..._. „.... „__........... „....„ _ :Member ..... .............. ..., „...„ . „. „......_.. „....„..._...„ _.._..... „. „...„ _ Member „._ -------- „._ ..._................. „...„... „ „... „_„ ._....„ CouncilApproved ..... „... .................................. _..__.. ...... ...._...._Date Disapproved .. ....... ... ._ ... ........ .......................... ..... ... ............ Date NUTS: 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. THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT ❑ WITH NO VARIANCES ❑ WITH VARIANCE(S) LISTED IN "REMARKS" NO OTHER SHORES ORDINANCES ANCES WILL BE P RMITTED, UN ESS PECIFICAILLYN ISTED BELOW. ALL OTHER APPLICABLE STATE AND COUNTY LAWS MUST BE COMPLIED WITH BY ALL PARTIES. Authorised S ?gnature Date FIRE DEPARTMENT PUBIC WORKS POLICE DEPARTMENT BUILDING DIRECTOR PLANNING & ZONING BOARD VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL: -- REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTORS ARE C" K'`O "r! EnCE OF Al I B1111 D- ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. 11 r S^ *., Miami-Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/4/2003 Applicant: Owner: MILLER JOB ADDRESS: 177 NE 103 Contractor AFFORDABLE IRRIGATION INC Local Phone: 305 -681 -6322 Plumbing Permit Permit Number: GILBERT ST PL2003 -93 Contractor's Address: 198 NW 139 ST Page 1 of 1 Parcel # 1121360130840 Legal Description: 36 52 41 3152 42 MIAMI SHORES SEC 5 PB 10-47 LOT 21 8, 22 BLK 122 LOT , i Total Fees: --� 3 a 0. DD Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 10/112003 Construction Value: $1,500.00 Work: LAWN SPRINKLER AND WELL IRRIGATION If there Is no permit package accessible on the lob -site for Insoectors to varifv_ thara —ill ho ^^ ° ^ ° ^ ° ^` °""" n- fee is $50.00, which must bet 8003 This Permit is granted to the contra AFFORDABLE IRRIGATION, INC- ordinances pertaining thereto and with Do IT RIGHT THE FIRST TIMEI P.O. BOX 601743 and approved by the proper nicipal Con. N MIAMI BEACH, FL 33160 authorization. A further col upoi TEL# 305 -661 -6322 FAX# 305- 661 -6321 ordinances and regulation pertaining by his agents, s wants or, m loyees. Sig In consi Von the issuance ton with the plans, drawings, statements o myself, my agent, servants or employe Signed: ©o of z 63 -64MTO Date �vwce a�aa 3 ®� WAMOV" ACH FIT 067006432 For rrx � _ ■nnnn❑'Ino +•nr.gnnr i.i ?i: Pnnnnn I I + ?I + ?1 +lls $ 0 -�0 8 —° Doffais . .... . . . ... .. .. . . . .. .. . . . . . . . . . . . ... . ....... .... t" g TI sj' • 1 Mss : � l /03 5-7of ee 7.: F , S70 sr / ut w AU d 11A (e,/0 5;.z5 6, /i ,9 ) APPLICATION FOR CERTIFICATE OF RE- OCCUPAINCY to re- occupy the single family residence known as : (address) hereby apply for cerdn' cate, i AJ Miami Shores, Florida. Legal Description: ..Lot: , - Block PB & PG: 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 such property. Applicant Date Print Name C9,e 0 P 2,e e r % For purposes of conducting the inspection required by Section 902 of the ilfami Shores Land Development and Zoning Code, please contact: 3 os - 0 e 1G l kC, lc_ h oe -s a y y 3os- Contact Name: _ �� ,.� Z �Z- Telephone: S/- 95'7ex•4 3 a/ Buyer Seller Realtor _�_ Company Name 60 Application Fee (S50) paid: Cash Check No. r Inspecte y: Approved Denied Date�b 0-a, Comments: PAGE 1 OF 2 CERTIFICATE OF RE- OCCUPAINCY On behalf of Mami Shores Village, Florida, the undersigned certifies that the property described in the above application has bee inspected for purposes of re- occupancy pursuant to ; Sections 901 and 902 of the Maori Shores Land Development and Zoning Code and that such property may be re- occupied by the above applicant for single- family residential purposes. SHORES VILLAGE, FLORIDA B.� Date of Certification: 7L`�T7� 001--"�'- THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE- FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE- FAMMU,Y DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY - REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION, THEREOF. PAGE 2 OF 2 Permit No...:: (� MIAM1 SHQRES VILLAGE - PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PWMBING PERMIT a . 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 m 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work.,a Owner's Name and Addres�____� � � Registered Architect and /or Engineer No. Street_ _ _. __---- -- - - -• Employing Plumber's Name__ - A - _._. _ No. __.Street___ ___ -- Loc ation and Legal Description Lot, Block Subdivision Number where k is -to be ed—No. s _ t _ .� Street and ber --.— State work to be perform and purpose of building (By Floors) —Z -__- __ ----- New Building - - -. .� _ __ -� ' - -- Remodeling— Addition _.___—_.__- Repairs _ _ ______- _.. - -- No. of Stories - _------- __ ..... _... } Size septic Tank— — Type of Tank capacity Feet of Drain Tile• ____- -__ -- Dist- Feet of Tank or Drain Field from Well_____ -_ .. ............ Nature of Water Supply. City—Well. _ Size of Soakage Pit Amount of Permit $ (Signed)— — _ Plumbing Inspector. The undersigned applcant 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 t59W 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 at licensed by'I'Miami Shores Village. �� Signed) Master Plumber. - STATE OF FLORIDA, SL COUNTY OF DADE. Before I me, the undersigned authority, a notary public, duly authorized to admiaiste r oaths and take acknowledgments, personally appears to me well �nown, and who, being by me first duly sworn, upon oath deposes and says that he is of the - Ye described construction, that he has carefully read the fforegoing application, and that he did sign the same, and that all fac therein by him stated are true. My Commission Expires Notary Public, State of Florida NOT$ A re- inspection fee of $1,00 will be made when such re- iuspection is made necessary by improper notice for inspection, or faul materials a d /or workmanship. CLOSETS BATH ! TUBE SMOWER$ LAVA- TORIES. SINKS SLOP SINK$ LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURE! CONTR. LIST CHECK - - SOPTIC TANK SEWER I'. CONN.! DRAIN FIELD SOAKAGE PIT GREASE' TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK Size septic Tank— — Type of Tank capacity Feet of Drain Tile• ____- -__ -- Dist- Feet of Tank or Drain Field from Well_____ -_ .. ............ Nature of Water Supply. City—Well. _ Size of Soakage Pit Amount of Permit $ (Signed)— — _ Plumbing Inspector. The undersigned applcant 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 t59W 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 at licensed by'I'Miami Shores Village. �� Signed) Master Plumber. - STATE OF FLORIDA, SL COUNTY OF DADE. Before I me, the undersigned authority, a notary public, duly authorized to admiaiste r oaths and take acknowledgments, personally appears to me well �nown, and who, being by me first duly sworn, upon oath deposes and says that he is of the - Ye described construction, that he has carefully read the fforegoing application, and that he did sign the same, and that all fac therein by him stated are true. My Commission Expires Notary Public, State of Florida NOT$ A re- inspection fee of $1,00 will be made when such re- iuspection is made necessary by improper notice for inspection, or faul materials a d /or workmanship. MIAMI SHORES VILIAGE PLUMBING INSPECTION DEPARTMEW APPLICATION FOR PLUMBING Permit No_ --r- Date - -- I / °�Z o Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subm' for the building ar o er structure herein described application is made in compliance and conformity with the Building Ordinance of i Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shares Village and all rules and reg ons of the Building Division of Miami Shores Village she'll be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of �ror Owner's Name and Address _ No. yl 11A, Registered Architect and/or __ - -- Employing Plumber's Name No. \ Stmt Location and Legal Descrip on Lot_ _ B ubdi Street and Number where work b to be performed No � StreeL State work to be performeS and purpose of building (By Floors) .............. Now - Building �' Remodeling Addition _ �. -- Repairs_ . -_. ' ;\ - -_. . No. of Stories___ ..... .... ._ Size Septic Tank Feet of Drain Tile. Nature of Water Supply: Amount of Permit $ pe of Tank _ .- .____Capacity - - - -. -- Feet of Tank or Drain Field from Well__ _ _ _ _ _ _..._..._.......... of Soakage ....... ......... Inspector. The undersigned applic ut for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Warlonexes 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 perms}; and will post or cause to be posted for inspection on to of the work such public notice or notices as are required by die Act. The undersigned agrees to employ only such sub'co1► war to be performed this permit, as are licensed by Miami Shores Village. � X/i _ ( Signed STATE OF FLORIDA, COUNTY OF DADE. Of Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac mowledgments, personally appeared to me well known, End 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 hire stated are tr e. My Commission Expires Notary Public, State of Florida NOTE: A re-hisvection fee of $1.00 will be made when each re- inspection is made-necessary by improper notice for inspection, or faulty materials and /or p. CLOSETS BATH TUBS �SNOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRtNKiNG FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD - SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP SPRKLR. WELL SYSTEM SWIM'G POOL CONTR. LIST -- - -- - -- - - - - - -. _. CHECK - Size Septic Tank Feet of Drain Tile. Nature of Water Supply: Amount of Permit $ pe of Tank _ .- .____Capacity - - - -. -- Feet of Tank or Drain Field from Well__ _ _ _ _ _ _..._..._.......... of Soakage ....... ......... Inspector. The undersigned applic ut for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Warlonexes 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 perms}; and will post or cause to be posted for inspection on to of the work such public notice or notices as are required by die Act. The undersigned agrees to employ only such sub'co1► war to be performed this permit, as are licensed by Miami Shores Village. � X/i _ ( Signed STATE OF FLORIDA, COUNTY OF DADE. Of Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac mowledgments, personally appeared to me well known, End 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 hire stated are tr e. My Commission Expires Notary Public, State of Florida NOTE: A re-hisvection fee of $1.00 will be made when each re- inspection is made-necessary by improper notice for inspection, or faulty materials and /or p. ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPAN HEATERS UNIT FEE BIDET L I G•HT OUTLETS CENTRAL HEAT I ING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEhfMY A/C (CENTRAL) DRIM lNG FaWAIN SERVICE SIZE IN AMPS DUCT WORK FLOCK FAIN SERVICE REPAIR/W0 WINGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UMSGROW TANKS LAVATORY OVEN ABOVE GROU140 TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASIER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT/3 COMP. MOTORS OVER 3- 5 HP MEO NICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORT ING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRAISFRS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIM+IINO POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANNA RELAY TELEVISION OUTLETS ORAINFIELO, 4` TILE/RES. VIOLATION PUMP 8 ABANDCIH SEPTIC TANK RE I INSPECTION SOAKAGE PIT CU. FT. CATCH BASIN 01 SCINGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANOPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING 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- in 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. � r Date - - - - - --------------------------------------- - - - - -- 19- Owner's Name and Address ___ r - _ 0 V- 4- / I _ - - - - - -- - ------- - - - - -- No--------- -- -- ------ - - - - -- Street-- ,t// Registered Architect and /or Engineer Name and address of licensed contra r-° Location and legal description of lot to be built on: Lot- - - - - -- �_L /- -' ---- - - - - -- Block.-- - - - - --- - �'-- - - - - -- Street and Number where work is to be State work to be done and purpose of building (by -------- _ ------ _------------- for no other purpose. New Building---- _ --------- --- - -- Remodeling----------- --------- - - - - -- Addition- ----- ---------- ---- - - - - -- Repairs --------------------- . ---- No. of Stories-_40%2- -- 9= - - -- To be constructed of__jC-__i_1 --------- Kind of foundation_______ - Roof Covering ______ :27�------------------------- Estimated Total cost of improvements $__,r____1 Cf' fi�_�-------------- Amount of Permit $__________ _ _ -- ----- - - - - -- ----------------------------------------------- Zone cubage required---------------- ------ -- 1 -`7- -- -0L ------- - - - - -- -Plan Cubage - - - - -- — - -------------------------------------------- Distance to next nearest building ---------------------------- - -------- ___ ----- _ ---------- Size of Building Lot__.,,' A 'n.o___ _ r _-------- _ ------ v ----- - __ -_____ Maximum live load to be borne by each I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent 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. ( Signed )- Remarks - - "GS,tis4 _ r STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, 4- notary public, duly aytlsorized to administer oynths and take acknowledgments, personally ap- peared 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 car fully read the foregoing application, and that he did sign the same, and that all facts therein by him stat ge tru , Permit No --- ---- ______I__ ____f ___________ Date_________ __ --------- / ------- R , wo o and Subscribed before Disapproved Date-------- - - - - -- ( Signed) ------------------------------------------------------------------------------------------------- Building Inspector NNING BOARD________ Chairm- - -- - - -- - - - -- - - -- - - -- - - -- - -- ----------------- - - - - -- Member - - -- - - - - -- - - -- -- - - - - - -- -- ----- - - - - -- Member ____ - ----- __ - - Council Ap ove _________ _ _____Date - -- - - - --- -- --------- -- - - - - -- - -- - - - -- - - -- -- --- --------------- - -- Not Public, S10. 5t lorida of Es'rgsi MY Co sion Expires-- My cam ion ;ras January is, 1950 $onzisd f�mari=n Surat, Gaa of its -do Member Member Disapproved 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 workmanship. / vv 14 dd 1 *161) o 4� 1 �� VV 1POkO00'. r MIAMI - SHORES VILLAGE, FLA. No 5938, JOB r C'�:�2•e9y� -�9* 53 i ADDRESS1 7 7 �Q INSPECTION TIME READY Z:�>i-t REMARKS: INSPECTOR DATE i I+ I- �- �B Owner + s / ,- t • ,- General re lob Subdivision No. Street r Ndmo,., Lic.No. r Add. or Phone Ltractor Lic.No. Add. or Phone Zone Req.Cu.Ft, Z % Plat Restriction Checked by s To Planning Board ___ `-///6 Approved Rejected Re- Submitted to P.B. Approved Rejected Plans & Spec. Checked by , ,Z Tlizabling Inspection Date By __ i_© -insp Uy Re -Insp By Roughing Fixtures Sewer _ Septic Tank Solar Heater Final Certificate V a To Council Approved Rejected J Bldg. Permit No. �7 d Date ✓ Fee /'" Cost �� { r Type �. 1 Stories Roof New Construction Alterations Repairs Plumbing Permit 110. Date yi,' Fee --''' Septic Tank it rl Sewer It tr Mis c 11 it tt New Const, Alteration Re I pairs -Electrical Permit PTO, Date Fee Fixtures IT - if Heater tr it Motors — ►► ---- it Mis c 11 n It Now Construction Alterat-,ion Fie-pairs Building Inspection D tc, ~.y Re-insp By Re -Insp By Foundation Beams & Lintels Final Final Clean -Up Tlizabling Inspection Date By __ i_© -insp Uy Re -Insp By Roughing Fixtures Sewer _ Septic Tank Solar Heater Final Certificate V ................. Permit No. _ Name 1 1 .. _.. .. _.., .. _ .,. _. �.,.... Address' 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 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or n A copy of approved plans and specifications must be kept at building during progress of the work. o�� 4O Date--- ------ - - - --- - 19- - - - - -- Owner's Name and Address ------ _� _ _ No.__ Street— _________ —_____ Registered Architect and /or Engineer_ ----------- ------- - - - - -_ - ------ - - -_ —_ _ __- Name and address of licensed contractor --.. Location and legal description of lot to be built on: Lot -- - - -- — Block---- - - - - -- -- S Street and Number where work is to be done ----- _ ---------- ____. State work �o be done and purpose of building (by floors) ----- C-- ---- - - - - -- - -- — - - - - - -- - -- — - -- -- ------ - ---- ---------- ------------- -------- - - - - -- -and for no other purpose. New Building --------- --------- ---- -- -- - - -- Remodeling- --- ------- --- - -- - -- Addition ---- - - /_X_- ---- ---- -- Repairs ---------------------------- No. of Stories-------- --- - - - - -- To be constructed of-------------- -- - - - - - -- Kind of fgundatiou - - - --- - ---------- - ---- ------------------------ Roof Covering ------------------------ --- >--------- a.%'1' O / Estimated Total cost of improvements $_____ 2 __ Amount of Permit $---- 1--'------------------- ___— ___ - -_ —_ Zone cubage required __ -------- __ ----- - --- _ _ _ _ — ___Plan Distance to next nearest building ------------ of Building Lot Maximum live load to be borne by each I hereby submit all 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 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 inspe�ctjon on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subc ors, on work to be performed under this permit, as are licensed by Miami Shores Village. e;Z j Remarks _ - -- -- - -- -- _ — - - - -_ (Signed)"' _�-// STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared----------- ---- - - - --- — -- - -- -- - -- - - -- — — - - -- - -- --- - - _ --------------- ____________ 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. � Permit No.__— S ,, ______________ Date— � Read, Sworn to and Subscribed before me. Disapproved---------- ------------------------ Date -- - -- -- -- - -- — - - -- - --------- -- - - - - -- -- - - - -- - - - - - - - -- - Notary Public, State of Florida (Signed) --------------------- ------------------ - - - - -- — - - — -- Building Inspector My Commission Expires ----- — __ —____— PLANNING BOARD ------ _— __e__ - -- ______DATE Chairman - - -- - _ -_ -- - -- — Member - - ---- -- --- -- - -- - -- - - -- - -- -- -- - -_ Member --------- - -- -- —_ -- -- Member _ —_ -- - -- - - - -- Member - - -- -- __ -- -- -- -- -- Member - -- -- - - - - -- — -- Council Approved---- ------------ - -- --- — - - -- - - - - -- - -Date Disapproved ---- -- ----------------- -- -- ----- -- - -- - — — —mate 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. • V Cj MIAMI SHORES VILLAGE 0� BUILDING DEPARTMENT O® 305- 795 -2204 Building) Inspection Request Date � 1� Type Insp'n-:F-1 r)cl f Art a Y r -) Permit No. E t O5 Z.3 - ) 2-34- Name "� O k-1 i5'C GI 1'O) V CJ Address 1 „ KIC I C3 ST Company ICY i Y71L, Hc)r>'1- ErCA-,Y 14 Phone # k ) -754- 02 '� 3 Inspection Date g ` 3 O S Approved Correction ❑�� Re- Insp'n Fee ❑ I 17 N E I C3 Sf ,2 if c� ao- MIAMI SHORES VILLAGE, FLA. N o 6141 ADDRESS L7 ;z /J . INSPECTION C- ,s0 —_ TIME READY .� 21 REMARKS: INSPECTOR 1) DATE � d ADDRESS ! /-j7 Al /I-,- CV- LEGAL,2 /-ram /2a _ S &-RECORD GARBAGE TAX - ... - - -_ �` '- _- '--- - - - - -, PAID BY -.. - - -_- °_ -_'- --- __ - - -_- °- YEAR ANNUALTAX - :....- PER700- USED,._. AMOUNT PAID DATE PAID - .__RECEIPT NUMBER Vo- fr /2• ® /2- -/ .i /2 - /.F q P��g Z-o 77 a4z- ,,, - -s - - r y as - MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE " 7& 194 ELECTRICAL PERMIT N® 5463 Contractor's - r`3 PLUMBING v License No. x::11 Work to be performed under this Permit aL G& Owner of r/ 1 ^� a Building 11:.x''' "a • l t w Architect Contractor ` or Builder''" Legal Lot Bl. Description Address of �� -> •t Gff Subdi- vision Value of aA -wo Prniect `�('�. Amt. of .Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowled a of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans o drawings or in the statements or specifications a xh�t he5umes respon- sibility for work done by his agents, servants or employees. j` r ` Signed: C.7 • .�:. ' By d� r 'j INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with al nances and reeggulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities Miami ShoreS`Village. In acceptin 4thq permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER v BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA 0 4 f G K= ,..,..",.. yr - DATE i '194_ BUILDIN ELECTRICAL PERMIT N? 4403 Contretor' PLUMBING Work to be performed under this Permit # Y Owner of T2ral '• & 1� A r Building Architect Contractor" or Builder 61'e IJz� e -, C/ e ° Legal Lot `" 01 131. .+ Description OL '4 Address of 1 11"), 1 Subdi- vision M Value of f.f' II Amt. of Prnieet : I ` e Permit ✓ �^ This permit is granted to the contractor or builder named above to construct the building or to uistall the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge,of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or .in the statem pts or specifications and that he sums respon- sibility for work done by his agents, servants or employees. '— Signed: IN^ CTOR By In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ��hnances aid p� ulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritlestof Miami S o sgVfllage. In accep0T910ftj permit nine responsibility for all work done by either myself, my agent, servant or employee. r CONTRXCTOR OR BU D ��7 BY AUTHORITY J This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or jn statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. /�'r /� 4 _Signed: By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with .allordinances andgeAulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritiTs of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING- DATE G' 0e 194 ELECTRICAL -,/PERMIT N° 4584 Contractor's %0 3 PLUMBING License No. Work to be performed under this Permit ��i i �,,. � '7'uw,� Owner of Building lam` -r Architect Contractor or Builder Legal Lot y) _ r �,1'�! I Bl. A, Subdi- (" 3 Description vision Address Buildinirof �/ 7 7 ,/ 0 3 Al /v _ Value of Project f I Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or jn statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. /�'r /� 4 _Signed: By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with .allordinances andgeAulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritiTs of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee CONTRACTOR OR BUILDER BY AUTHORITY I MIAMI SHORES VILLAGE, FLORIDA i BUILDING DATE ELECTRICAL wO PERMIT N° 4596 Contractor's PLUMBING License No. �i► Work to be performed under this Permit -- X46ti �,,j OF 4 Owner of �� r�4h✓"" II Building Architect Contractor 4 or Builder `"' Legal Lot ,k Y I Bl. Description Address of Rni 77 AI E lr in Cr o Subdi-^^ vision Amt. Permit This permit s'granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or the �ta�ents or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. 1' ♦` Signed: BY �� INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with tordinances Nnd'realations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authkodes of Miami holes Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILD IM AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE_ -194,1 ELECTRICAL PERMIT N° 4607 Contractor's s--+ PLUMBING License No. Work to be performed under this Permit r't' -�ro;!s o'r•..J� -�, Owner Building n %yt 14 g Architect Contractor or Builder Legal Lot Bl. Description Address of r Subdi- vision Value of Amt. of "S Permit / This permit is grante to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawin s or in the oatements or specifications and that he assup a respon- sibility for work done by his agents, servants or employees. '`j j� t Signed: Bye' ! INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with aallb� ppdinances and rtg, ns pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper auth ;FAAs'bf Miami Shores VVililllage. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. (/ /Lf CONTRACTOR OR BUILDER BY'� AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building { MIAMI SHORES VILLAGE. FLORIDA ❑ DATE t 195 ' PERMIT N© 5555 Contractor's License No. /4 _ ❑ Work to be performed under this Permit Architect — Contractor or Builder Legal Lot Description — I I Bl. — Subdi- vision Address of Value of I! Amount of Building f '' Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with 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 furthcr condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he -4tssumes responsibility for work done by his agents, servants or employees. Signed: c BY:s INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE 19 ELECTRICAL PLUMBING ❑ PERMIT N° 5237 License t No. is ROOFING ❑ ❑ Work to be performed under this Permit_ Owner of Building . Architect Contractor or Builder Legal Lot Description _ BL Subdi- vision Address of Value of Amount of Building Project $ - -- Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: _ — -- INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY .N.0, te a. 0' I 1. BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ El Owner of Building . Architect _. Contractor or Builder _ Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA DATE " �' 19 -gyp PERMIT 1� % 5600 Contractor's j License No.. - Work to be performed under this Subdi- Bl. vision Address of I Value of Amount of Building Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed: _ INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac• cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY eceor �' -� - MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE 194—L ELECTRICAL PERMIT N° 4468 Contractor's License No.- PLUMBING Work to be performed under this Permit-- Owner of II Building Architect Contractor or Builder Legal Lot Bl. Description Subdi vision Address of f r"t -7 ` 3 Value of II Amt. of r � J Building i d X , Project Permit �/ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. ,V; aro Signed: By ailcF `i�0 INSPECTOR 1 In consideration of the issuance tome of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ELECTRICAL PERMIT N?. ° ., 4558 PLUMBING Work to be performed under this Permi Owner of Building Architect Contractor or Builder Legal Lot Bl. Description Address of Subdi- vision Value of DATE 194— Contractor's License No._ Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in a appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in complianc with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may e 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 conditio upo which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of th or nances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he a mes respon- sibility for work done by his agents, servants or employees. Signed: t — — By. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with' the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting -this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE' 4,# 194-4 ELECTRICAL PERMIT N° 4584 Contractor's PLUMBING License No.— �� Work to be performed under this Permit%'�"''K Owner of Building Architect Contractor or Builder Legal Lot yr� t t' .� "�r II Bl. Description Address of {! BuildinLy Subdi- vision Value of Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in /he. appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in com yman with anyplans, drawings, statements or specifications that may have been submitted to and approved by the proper'municipal authorities. This Permit e 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 owhich this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or tlW statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. 1' Signed: 4r•° By �. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this. permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA DATE 17 A` Contractor's License No. BUILDING ELECTRICAL PERMIT N?i 4596 ' PLUMBING Work to be performed under this Permit— Owner of Building Architect Contractor or Builder Legal Lot Description Address of Bl. Subdi- vision Value of Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compl4_h\ithis ny plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit ed 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 u permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the nd regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the state ents or specifications and that he an- sibility for work done-by his agents, servants or employees. �,_ Signed: By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING DATE ELECTRICAL PERMIT N° 4601 r Contractor's PLUMBING License No._ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Bl. , Description° I Address of Subdi- vision Value of ,4 194— Amt. of Permit f This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with 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 ay evoked 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 u n hi this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the or, nces a regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he ass respon- sibility for work done by his agents, servants or employees.` Signed: INSPECTOR By In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ;LECTRICAL PERMIT . N?: 4403 'LUMBING Work to be performed under this Permi )wner of I iuilding i achitect contractor .r t Vf it Builder' ,egal Lot Bl. Subdi- vision DAT Contractor's License No._ 194.— escnp on - Wdress of �, Value of Amt. of ` , � 3uilding Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device describe in the appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any fans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked I 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 ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- ibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting thin permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA UILDING LECTRICAL PERMIT N° 5463 LUMBING Work to be performed under this Permi owner of uilding rchitect bntractor r Builder egal Lot I) Bl. lescription .ddress of nilrlinv Subdi- vision Value of DATE 194 Contractor's License No. Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- ition herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t 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 rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he p9sumes respon- ility for work done by his agents, servants or employees. Signed: INSPECTOR By In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either inyself,,my agent, servant or employee. F'+ CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUII.DING ❑ DATE 6 - S____]__J 95 ELECTRICAL ❑ PERMIT W? 13523 Contractor's PLUMBING ❑ License No ROOFING ❑ Work to be performed under this Permit Owner, Buildinc Architec ,,;ontrac or Build Legal Descripi Address Buildinc �f `,....�.;.� � '�✓ rte``'-` A }'` � w ;t q for er Lot I) Bl, Subdi- :ion vision . of Value of Amt. of Project $ Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR tUIEDER BY AUTHORITY Miami Shores Village .. s, Building Department JUL 12 Ml 1 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ------ BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building ( Electrical Owner's Name (Fee Simple Titleholdery� b__ Owner's Address r7.7 ,L9 12' Cit e .S4, o State I-'-�.. Tenant/Lessee Name 4 5u.00 V,li�,1j. . JUL y 2 P,,"j cat G43-1. Permit No. � .WS ,`� T Master Permit No. /_/ 0 Z-1-9 Plumbing Mechanical Roofing Zip=;�/ i3 Phone # Job Address where the work is being one %% 7 City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO M _ -6i�?3- Contractor's Company Name Phone # i j _cf �� ' Contractor's Address r city 01 j,— State Zip- /� Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit _/ 2a Square Footage Of Work: Q g Type of Work: Describe Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace El Demolition Submittal Fee S od Permit Fee $ CCF S 0 • X00 CO /CC Notary $ Training/Education Fee S d .2-0 Technology Fee $ -2.S0 Scanning $ 3 ,C�o Radon $ Zoning Bond $ Code Enforcement S Structural Plan Review. $ Total Fee Now Due $ 30, (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip_ Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding $'2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence such posted notice, the inspection will not be approved and a reinspection fee will be charged. Si !�- 1'vsVir .fvrS Signature Owner or Agent ' Contractor The foregoi instrument-was - acknowledged before me this -�- - - -The foregoin instrument- was acknowl ged b me this day of ../u! 20 by day of✓ 206j-', by Da who is personally known to me or who has produced who is personalfy known to me or who has produced As identification and who did take an oath as identification and who did take an oath. NOTARY PUB NOTARY PUBLIC: ,�,�rrara ° a ®rz Sign: . pu Oaf`, Sign: Barbara A COMO i �Fw Prin t: f 3G ;CO My Commissson QQ3 in�("ii X31 Print: i M„ 'E �fr0 .. AF i4 My Commi Sion Expires: My C ssion Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED B Plans Examiner Engineer Chc 12/15/03 Zoning � SN�.�i,F„s h i• i i i• i i• i i �� ....... .... PERMIT APPLICATION .Master Permit No. • *�;ba+jy Pirinit No. • • • Step 1. Complete the attached permit application whicl4&tstbe 1igg&b '•wt%a_niooert}cowner and Qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate proces'.ipg pf gotf aDpQcpQod'If rodl"yig work will be done, a roofing application must be submit- ted along with this permit application. • • • • • • • • • Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: �i�d�" �� hem-3I . Address Apt. City State Zip Folio Number Lot Block Description of Work lown f' ��111��P_ .4— !/� _l I a \�OAII C71� Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building New Construction Electrical Enclosure Mechanical Alteration Exterior Plumbing Repair LPGX Alteration Interior Roofing Demolish Fence Relocation of Structure Other Shell Only ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER Name Address Home Telephone Business Telephone Fax s• Value of Work I, E D Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE ( ✓) Chu. Contractor Revision I _ Extension TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior ✓ Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'1 Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name rrc� o `, fie c License No. Address i Q NA-k o t ,err 331 t�'R Telephone° l5i 5 1 '_� � Fax_ �b) Qualifier Name 1 k lv 5 W �� Page 2 . . . . . • .... ....... . PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING QECE>S/Eb YOUR JVALIITATEE1PI!RMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTIOMare limRL*d*to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL MKMRE1: 11,0& DIR'CAMDEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED U E*QJ1Pb1E&T:9 VV,fIICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. ' ' ' ' ' ' ' ' ' 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. ')AVIT - Please reac Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL; EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, I" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FL DA, COUNTY OF MIAMI -DADE Kignat4e of Owne �^ Q0yk t Se- t Print Name %V Sworn to and subscD))ed before me this _ day of f Notary SEAL: `►* Marco T Rows * *MY Commission CC861818 1• ?ein,� Expires August 9, 2003 Personally known OR, Produced Identification STATE IDA, COU Y OF MIAMI -DADE e 3 of Contractor / Q ier m- R �A4._ Print Name Sworn to and subscribed before me this day of , Si �10 tat rida .Commission # CC 866406 S -c. Expires Oct. 11, 2003 Bonded Thru w „set', Atlantic Bonding Co., Inc ersonally n 6 OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Page 3 • • . . . • • • . • • PERMIT APPLICATION • •• I INSTRUCTIONS: Please indicate the type of wo4bei4g pejR36 e4 ajid.ggantity(ies) in the space provided below. I ELECTRICAL Minimum Fee A/C Central, Tons Dryer ; ; ; 0 M let„ Elppliar a A/C Wall/Win. Tons Service Repair Dryer Vents, Number of Paint Booth Ventilation, Cost A/C Central 1 -3 Ton Air Handler, Tons Fan Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections OrutfetVill Barbecue Service, Temporary Fire Sprinkler System Process/Pressure Piping A/C Central 4 -7 Ton Bath Fan- Vented, # Fire Pump Fireplaces, Number of Pressure Vessel Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles ( Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Sem, Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition ` Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY. TYPE QTY. TYPE QTY. TYPE Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons TYPE Drains, Roof Cooling Tower Heating Strips, each Vent Hood, Cost TYPE Miscellaneous Fixture A/C Wall/Win. Tons TYPF Soakage Pit Dryer Vents, Number of Paint Booth Ventilation, Cost Bath Tub Air Handler, Tons Drinking Fountain Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Miscellaneous Repairs Barbecue Solar Water Heater Fire Sprinkler System Process/Pressure Piping Bidet Bath Fan- Vented, # Filter Replace Fireplaces, Number of Pressure Vessel Pool Piping PLtTMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPF Soakage Pit Q'I-Y. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler ( Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well ` Laundry Tray Septic Connection Water Heater Drainfield, 4" Tlle/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply RECEIVED AND REVIEWED BY DATE: Page 4 • • • • • • • • • • • • ' PERMIT APPLICATION FOFFFICE USE ONLY CHECKLIST ❑ OWNER -BUILDER FORM ❑ PROOF OF 6WNI&SHIIS ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) (Attach) ❑ FIRE DEPARTMENT ❑ H0 / D$k1VIA VR ©VAC •' ❑ BPR APPROVAL (Restaurants) APPROVAL (Commercial I (�eptici�ewei) •. • •.. multi - family) ❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION (New Construction) (New Construction) (On File) ❑ OTHER ❑ OTHER (Specify & Attach) (Specify & Attach) PERNIIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary REVIEWED AND PREPARED BY $ Y� $ -tae $ _! r z% (sq.ft. = x/1000 x 0.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official TOTAL $ 4q)" DATE: Revised July 2001 10050 N.E. 2- AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ' ' / Job 'Address /7q q /116 Tax Folio y d 4#0 Legal Description X1"41-;? z At 12 7 _ Owner_. essee / Tenant Master Permit 10 e-16 ner's Address 12 2 do Phone 7rS -2 Contracting Co. } Address Qualifier_ C(/�,L Z SS# - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN W RK DESCRIPTION 17')q41r7 PU vR�S <ZPA)Ce oA) Squar(e Ft t Estimated Cost(value)`=- 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, ROOF NG nd MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing informati n ac e d that all work will be done in compliance with all applicable laws regulating cons c 'o on'ng. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Signatulre f qtr ctor or Owner - Builder Date Date Notary as to Owner afd /or Condo President to y as to My Commission Expires: y Commission x .f 11afiCtl7516� FEES: PERMIT RADON C.C.F. 6 10 NOTARY pP. TOTAL DUE APPROVED: Fire 4. } Other Zoning Building� Electrical Mechanical Plumbing Engineering E ,P PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 211,01 9 q Job Address ( 1 Pi &f 3 � ST Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant 5 a S'E�7- -TV--7A \J 5 /Ok Master Permit # No Owner's Address 1--7-7 N ` to 3V yl ST Phone/ Contracctinng Co. \/ Address State # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION Square Ft. Municipal # SS# _ Competency # Address Address Address Phone Ins. Co. PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN A (ti j c 1 (S 1 E-J CJS Estimated Cost (value))( T' 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. OWNERS 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: ( n/ FEES: PERMIT J y RADON APPROVED: Zoning Notarypeo Con My Commission C.C.F. t 60 NOTARY r 6 N s ::)- _5,0- tract r or Own Date Exp Y PUBLIC SPATE OF ]FLORIDA CAMM16510N NO. CC71 ,4103 MY COMMTSBION EXP. MAR 1 BOND TOTAL DUE Building d Electrical Mechanical Plumbing Structural Engineer -q�- - ( 2- 2-,0 9 XignaturdVC roctor r6 /2 -B Notarypeo Con My Commission C.C.F. t 60 NOTARY r 6 N s ::)- _5,0- tract r or Own Date Exp Y PUBLIC SPATE OF ]FLORIDA CAMM16510N NO. CC71 ,4103 MY COMMTSBION EXP. MAR 1 BOND TOTAL DUE Building d Electrical Mechanical Plumbing Structural Engineer PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date O Job Address / 7 / / / CF A8 `� Tax Folio Legal Description Historically Designated: Yes No ~Owner / Tenant i o ' Master Permit # b. l✓ Owner's Address `. t L: -�, Phones; Contracting Co. �i4 N.S aH G'¢ Address / `7r .. 1.cJ ¢ ', °� -3713 Qualifier /tst. (st/V o 0 7 /9YZ O Cpl i r/ Phone 4- ¢ -3 — & gO 8 [% State # Architect/Engineer Bonding Company Mortgagor Municipal # 7d c OODD,-�-4 Competency # Ins. Co. 05 Address Permit Type (circle one): BUILDING (ELECTRICAL) PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �� `� l ce Square Ft. Estimated Cost (value)d� . WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR DIPROVEMENTS 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. Signature �f wner and/or Condo President Date Notary as to er S;ondo o' �� `y SE �LI My Commission es: Bl� MARY MORENC) CENr11YASSION NUMBER 4 ' ® CC606964 �O F U'EC. FEES: PERMIT ®0f QiADON APPROVED: Zoning Building vo ® 2 /00 Signature of Contractor or Own ,06ilder Date Notary as t AR SsAI Date My Commi P xpir� MARY MORENO V11 /* COMMISSION NUMBER ? CC606964 � MY COMM FVo� DEC. 10.2000 C.C.F. ( P 0 NOTARY 0 `- BOND TOTAL DUE fP'�iI� Mechanical Plumbing Structural Engineer 0 �r�� P,%� U I r,_�, T PI- U 1 77 rx� I x F 4e, i4 A� CIO '14 Q V_3 C, A wV�'- Z J_ IL-( c O 1.4 0 Yx. \0 A r6-It MORENO 3641 S.W. 2i��'-,Mlain* fbvij*%3313 Phone: (305),03-8808 • Bqppw MIAMI SHORES VILLAGE .*° PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT PermitNo ------ -------------------------- Date-------- - - - - -- ----------------- - - - - -- -- -- - - - IL Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the uilding 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. �/ Street_ !% �'_L" ------ /-0 -- - - 't -- - lr "! Owner's Name and Address____________ N- ---------- l_____�__ R ' AArh' d E / . eg>stere c >tect an or nr, ---------- - - - - -- - -- -- ------------------------------------------------------------------------------- ---- - - - - - -- �.o Employing Plumber's Name - - No b /------------ ------ - - - - -- Street - - - -i - -- // - - - - - -- � :- Location and Legal Description Lot --------- ._f_f__ __ ______________________ Block -__— ' ---------------------- Subdivision ------ ....---------- Street and Number where work is to be performed-No -------- Z ,-------------- --------------------- ---- -- - --- S treet - -- oov --- -- I/ I/0 -Z sK j � - State work to be performed and purpose of building (By Floors)___________________________ _______________________________ ________ _,_____________- _- _____________ New Building ----------- '_'_ -------------- __ ------ Remodeling ____________________ Addition__ - J01 ----------------- Repairs -------------------------- No. of Stories ----------- SizeSeptic Tank--------------- --- -- - - - - -- ------- - - - - -- -Type of Tank-------------------------------------- --- ----------------- - - - - -- Capacity Feet of Drain Tile ------------------------------------------------ Dist. Feet of Tank or Drain Field from Well ---------------------------------- Nature of Water Supply: City -W of Soakage ------------------------------------------------------------------------------------------------ --------------- -- -- - --- -------------------------------------------------------------- ------- - - - - -- 7 -------------------------------------------- Amountof 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 ork to be performed under this permit, as are licensed by Miami Shores Village. / (Signed)-.; - --- - - - -- - -- _ ---------------- - - - - - t w �- -- °s • Master Plumber. 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. 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 workmanship. BATH LAVA- SLOP LAUNDRY CATCH FLOOR DRINKING TOTAL CLOSETS TUBS SHOWERS TORIES SINKS SINKS TUBS URINALS BASIN DRAIN FoUNT'NS FIXTURES CONTR. LIST - CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SW IM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CONTR. LIST CHECK SizeSeptic Tank--------------- --- -- - - - - -- ------- - - - - -- -Type of Tank-------------------------------------- --- ----------------- - - - - -- Capacity Feet of Drain Tile ------------------------------------------------ Dist. Feet of Tank or Drain Field from Well ---------------------------------- Nature of Water Supply: City -W of Soakage ------------------------------------------------------------------------------------------------ --------------- -- -- - --- -------------------------------------------------------------- ------- - - - - -- 7 -------------------------------------------- Amountof 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 ork to be performed under this permit, as are licensed by Miami Shores Village. / (Signed)-.; - --- - - - -- - -- _ ---------------- - - - - - t w �- -- °s • Master Plumber. 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. 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 workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit NO ------ r Date_________ T 7" 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 ___!_ _� r �'� � 7 7 N L' /O ______� �� ------- -- -- -- No.__________ -1 -- - - - - -. Street- -- - - - - -_ _--------- -_____�. /k, M. Sol W e 2 Registered Architect and /or Engineer ___�_— e _ —� ____— ------------------- ---- — _______ —� t A�L�Rs f LF ere,C C°' -- - - -- -- No ��, -- -- — - Street__!V_e_ 2 0 �►iC Employing Electrician's Name ____________�_ —__— ------- - - - - -- Location and Legal Description Lot ------- — A r_ —'`_ j Z__— -------- — --------- Block ----------- � �_'__- -------------- Subdivision ------ _ ---- — ---- _— _______ —___ Street and Number where work is to be performed— No.-- ______S4,W _____ -_____ Street -------------- — ----- — ----- — ---- — --- ____---------------- ------------------------------------------ State work to be performed and purpose of building (By Floors) --------------- — --- ----------------------------------------------------------------------------------------- New Building ------------ ---------------- Remodeling ----------------------------- Addition --------------------------- Repairs ----------------------- No. of Stories.._ - - - -� "- Overhead 1 �2.r Main Fuses_________________ Service Underground Size Feeders-___________ Conduit -__�— Main Sw._-- _____�_ —_____ Amps. —_ _____ Amps. Type of Installation —Conduit ----- Y_J__ -__ Tubing _ -___ k�_ B.X.L ----------------- Metal Moulding —___ ----------------- — --- — ------------ __— ---- -- __ ------- —__ --- — -------------------------------- -- --------- ----- --- ------------ ------ -------- -- ------------------- - ------------------------------------------------- ----- -------- ---- -- --- -- - -- Amount of Permit $ ---------- __� !-- ___----- _ --- - - -_— __(Signed) ---------- ______ --------------------------------------------- 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 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Master Electrican. 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. 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 workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECnE'P'T's FIXTURES NO.L/kMPs REFRIG. OUTLET IRON RANGE RANGE OUTLET OUTLET GOWN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST L ' �_ ! J 11� CHECK ENT. SW. DIST. CAB. I SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST / (i j--�'-�— v�- CHECK Overhead 1 �2.r Main Fuses_________________ Service Underground Size Feeders-___________ Conduit -__�— Main Sw._-- _____�_ —_____ Amps. —_ _____ Amps. Type of Installation —Conduit ----- Y_J__ -__ Tubing _ -___ k�_ B.X.L ----------------- Metal Moulding —___ ----------------- — --- — ------------ __— ---- -- __ ------- —__ --- — -------------------------------- -- --------- ----- --- ------------ ------ -------- -- ------------------- - ------------------------------------------------- ----- -------- ---- -- --- -- - -- Amount of Permit $ ---------- __� !-- ___----- _ --- - - -_— __(Signed) ---------- ______ --------------------------------------------- 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 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Master Electrican. 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. 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 workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. - - - #A(O- Application � I -- - - - -__ Date-- __ - - - is hereby 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 wor Owner's Name and Address Registered Architect and /or Engineer ___________— Employing Electrician's Name ------------- Location and Legal Description Lot --------- .•"tom Street and Number where work is to be performed —No Street------------------- - ---- - -------------- _ No------------ — ---------- --- -------- Street - - - --------------------- - -� —�- L- - - - Subdivision__ -�? - - ---- ------ - - - - -- State work to be performed and purpose of building (By Floors) -------------- ---- New Building ---- ------ Y___----------------- Remodeling--------- ------ --- --- -- - -- -- Addition ..--- -- -- ----------- - - - - -- Repairs------------ ---------- - - - - -- No. of Stories..------- -- - - -- Service Overhead Size Feeders_ _______________ Conduit ------ - -__--- Main Sw --------- __- ------ Amps. -- ______ Main Fuses ------ - ---------------- Amps. Underground Type of Installation--Conduit ------ _-------- Tubing -------------- - B.X.L ----------------- Metal Moulding _— --- _ ----- - --------- ___— _______— _________________ —_ --- ---------- – --------- – --------- — ---------- -- -------------------------------- ---------- — --- – ---- – ---- — --- – ------ -- ---- ------ -- - - -- -- ---- Amount of Permit $_— _____,L_— _________ — __________ (Signed) - - -- 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 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) - - - - = - —r --------------------------- aster Electrican. STATE OF FLORIDA,'''' 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 be 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 workmanship. SWITCH LIGHT PLUG FIXTURES REFRIG. IRON RANGE RANGE WATER W. HEAT. - SPACE STR;P TOTAL OUTLETS OUTLETS RECE'P'T'S No.LAMPS OUTLET OUTLET OUTLET CONN. HEATER CONN. HEATER HEATER CONTR. LIST CHECK ENT. DIST. SERVICE SERVICE MOTORS MOTORS NEON RADIO TOTAL SW. CAB. TEMP. PERM. 0-1 HP 1 -5 HP TRANS. CONTR. LIST CHECK Service Overhead Size Feeders_ _______________ Conduit ------ - -__--- Main Sw --------- __- ------ Amps. -- ______ Main Fuses ------ - ---------------- Amps. Underground Type of Installation--Conduit ------ _-------- Tubing -------------- - B.X.L ----------------- Metal Moulding _— --- _ ----- - --------- ___— _______— _________________ —_ --- ---------- – --------- – --------- — ---------- -- -------------------------------- ---------- — --- – ---- – ---- — --- – ------ -- ---- ------ -- - - -- -- ---- Amount of Permit $_— _____,L_— _________ — __________ (Signed) - - -- 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 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) - - - - = - —r --------------------------- aster Electrican. STATE OF FLORIDA,'''' 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 be 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 workmanship.