PAINTPERMIT APPLICATION
j FO�R�/)MIAMI SHORES VILLAGE
Date tic 1 `� f Job Address � It/ , C l)_ / �Gi Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenants 7 j ce � c 5 T ( ` `O Master Permit #
Owner's Address Phone--- _? d / ` 5--'6C6
Contracting Co.Address
Qualifier SS# -
State #
Architect/Engineer
Bonding Company
Municipal #
Competency #
Address
Address
Mortgagor Address
Phone
Ins. Co.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION c 44 c/ S G�'' 2 / /<_
l
Square Ft.
Estimated Cost (value) . '—OL2
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR E"ROVEMENTS 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
construction and zoning. Furthermore, I authorize the above -named contractor to do the m
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
applicable laws regulating
& C;Z,?
Si u6 of Contractor Owner -Builder Date
otary as to SEAL Date
My Commissi ue�19"' s yAppApITA MONTIel
er
of vti _..
FEES: PERMIT 'J to —RADON C.C.F. b NOTARY ^ BOND
APPROVED: TOTAL DUE_ ss
Zoning
Building Electrical
Mechanical Plumbing Structural Engineer
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER
TO RETAIN COPY)
Date / Job Address_
E
S% Tax
Folio
o)S,3
I U
71
Legal Description
A6
// ' Lt #M Master
Permit #
Owner / Lessee / Tenant _ �r1 �`I�
&L'k
dG' hA t, L1'
Owner's Address C;�S3 /P�E 7 a
S f
Phone / ,5V- 6 lj
Contracting Co. Address
Qualifier SS# -
State #
Architect/Engineer
Bonding Company
Mortgagor
Competency#
Address
Address
Address
Permit Type (circle one): BUILDINGELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
Phone
Ins. Co.
WORK DESCRIPTION f `�� j r / rc ac, c• 5hu 7`�"�>� S /,i
4 I. -
Square Ft.
00
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 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.
� C[r►
Signature of Owner and/or Condo President
Date:
y 1 fw Aw 11
N t r as to Owner and/or/ Coado President
M, Commission Expires:
PERMIT FEE:
Signature of Contractor or Owner -Builder
Date:
Notary as to Contractor or Owner -Builder
My Commission Expires:
APPROVED: Fire Other
Zoning Building Ak)7/ ( Electrical
Mechanical Plumbing Engineering
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 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.
Date `S 1 19 90
Owners Name and Address' No. I Street _.. .
Registered Architect andior Engineer --
Name and address of licensed contractor --
Location and legal description of lot to be built on:
LotL�C.�d`•Block_ �_[p Subdivision A e&m I A M 0 d 19e-
Street and Number where work is to be done S3 �Ea ��•
State work to be done and purpose of building (by floors), state exterior colors (submit samples) 'V ! "41 C.
New Building _ _ Remodeling Addition Repairs.
To be constructed of._ C? A S ___— — __ Kind of foundation Roof Covering
Estimated Total cost of improvements S C,7 �� Amount of Permit S
Zone Cubage required
Distance to next nearest building
Maximum live load to be borne by each floor
Plan Cubage
Size of Building Lot
and for no other purpose
No. of Stories v2'
I hereby submit all 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 obligatons 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 (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
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
to me well known.
and that he did sign the same, and that all facts therein ky him stated are true.
Permit No %.2 c/ Date oC Read. Sworn to and Subscribed before me.
f
Disapproved Date --
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires _
PLANNING BOARD DATE
Chairman Member
Member Member
Member - Member
Council Approved
— , Date Disapproved
Date
NOTE: A charge of $25.00 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 $25.00 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 ar other stricture herein described. This application is mad.e 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 sluill 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.
Date.____ ��`'r'' lf) sI �---........19_-_'.;�
- --
Owner's Name and Address... No ------------------------- Street..------_--_._
Registered Architect and/or Engineer._
Name and address of licensed contractor_Y��-
Location and legal description of lot to be built on:
Lot ------ -------------- ..... ....... Block -... -.-- SubdiA form__
Street and Number where work is to be ------------
----
State work to be done and purpose of building (by floors) -- -
- —.---------
`___._ for no other purpose.
New Building_ Remodeling -------------------------- Addi tion Repairs ------- No. of Stories-_.
To be constructed of---------------------------- Kind of foundation..-- _ Roof Covering ------------ -----------------------------------
Estimated Total cost of improvements 6 o --
------- -----Amount of Permit $
Zone cubage required--..-.-. - --.flan 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 builc ling. All notices with reference to the building and its construction may
be sent
The undersigned applicant for this building permit does here} ')y certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, beingSection 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will r uire sir ni]ar com liance from all contractors or sub -contractors employed by him
in the work to be performed under this permit, and will require
or c ause to be posted for inspection on the site of the work such ppublic notice
or notices as are required by the Act. The undersigned agrees to a ,nploy onlsuch subcontract on work to be perfo ed 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 a uthorized 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 so
of the above described construction, that he has carefully read thr
therein by him stated are true.
Permit No._ 1— 4 ___ _ Date-,—'1L
Disapproved
(Signed)I 44r_
C
Building Inspector
PLANNING M?7.
Chairman
Member ..___�_ •.•._
Member ----------- -�--
CouncilApproved -------------------------------------------------------------------------- Date
NOTE: A charge of $1.00 will be made for making correctio
the Planning Board.
A re -inspection fee of $1.00 will be charged when such re -ins
materials and/or workmanship.
,ys that he is the..__.-�_
foregoing application, and that he did sign the same, and that all facts
Read, Sworn to and Subscribed before me.
----------
Notary Public, State of Florida
My Commission Expires_________________________.
---....DATE
Member
MemberT-_-
Member•_------------- --.._..--
Disapproved--- -- -------------•------------------ --- ----------- ..—Date
ns or changes to this application after approval has been obtained from
,pection is made necessary by improper notice for inspection or faulty