1037 NE 91 Terr (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address / � 7 /l )E Q VV Tax Folio
Historically Designated: Yes No
Owner /Lessee / Tenant) a 11 CQ C Y 1( l (So rI O (I Q _ Master Permit # ZIG ? g
Owner's Address 5 a vr\Q as RbU V ' 'C_ Phone (S - q
Contracting Co. 5R__ c f I V' 1 r( V f Address
Qualifier j 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
WORK DESCRIPTION, i.
n417t t‘ic_)k‘
Square Ft Estimated Cost (value) a — 60 (")
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 constructio and zoning. Furthermore, I authorize the above -named contractor to do the wprk stated.
of ure of r s r Condo President
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT e l -6) RADON
APPROVED:
Zoning Building
Mechanical
Date
Plumbing
f
71
f Contrac
er- Builder Date
• 692 e/
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
/ -2 9 -97
�-
C.C.F. 0 NOTARY - BOND
Electrical
TOTAL DUE
Engineering
Architect /Engineer
Bonding Company
Mortgagor
Commission Ex,
** * * * ENV
FEES: PERMIT ' , " 2 r
APPROVED:
Zoning
PERMIT ,APPLICATION FOR MIAMI SHORES VILLAGE
Job Address lUtt.. 6 n✓ Tax Folio 7 V/ x.705" ®/ a25V7
Date 0- f /,
Legal Description ZCJf- 3-4e/2_ 446 •A } fig 4,
er / Lessee / Tenant "W . ( n S • `L. JGAL R4+2Sck_
Owner's Address I bV1 tJ f , ' \ - ,9' .R • Phone
Contracting Co. c -vif Z- iii Gnii Sla t /C1 (o I L/-Z,- Address SS3 ' ,S \Jtd1 clot 6k
Qualifier 6u, r o'r' aL , SS#
ca-z,
State # o S S 3°11 Municipal # Competency # Ins.Co.
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION PPPc p 7 10ft (1E- K -
Square Ft. Estimated Cost(value) 0 -0 O
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 t e abov; -named contractor to do the work stated.
"er and /or Condo President
N. ary as to Owner and /or Cond L P E ��s ident
?I MY COMMISSION N CC 222191 EXPIRES
• J _ %ptember t6,1996 INC.
BONDED THRU TROY FAIN INSURANCE.
* *
Mechanical
Address
Address
Address
Fire
* *
Plumbing
Master Permit #
Signa
Date'
*
Phone (o So \ `;\c -Of
of Contractor or Owner- Builder
Not y as to Co , ractor or Owner -Buil
My Commission:
•
rat
tre s : ANA E. LEON
=_ MY COMMISSION N CC 222191 EXPIRES
September 18, 1996
BONDED THRU TROY FAIN INSURANCE, INC.
* * * **
RADON C.C.F. 1f ' NOTARY TOTAL DUE
Other
Building `'� ) a'f't✓/ 1 Electrical
Engineering
•
v �-
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/
'
1
MIAM 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.
Owner's Name and Addressf +'—T6 W' M/fatip I v'
Registered Architect and/or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot (t /'F 1 Y l Block / Subdivision
Street and Number where work is to be done / () 37 A/&
State work to be done and purpose of building (by floors), state exterior colors (submit samples) 4 S
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of // Kind of foundation Roof Covering
Estimated 'Ibtal cost of improvements S f"' 000 Amount of Permit $ if 1 C
Zone cubage required Plan Cubage 1 c X10 � l ` t°fv
a
Distance to next nearest building Size of Building Lot I 1 r
Maximum live load to be borne by each floor
1 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 a s Co ploy only such s , ontractors. o work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
}SS.
9 Qa
Date 7 ,( � Q
19 CA.
. ^y �
No. / 0 � L Street r ; f %7 i '?
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.
Permit No.
(Signed)
Date
Disapproved A� 1 �,�_ , Date
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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 en obtained from the Planning Board.
A re- inspection fee of $25.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
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APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the
State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
Owner's Name and Address C ri IJL✓ • ' '' 1 urz
Registered Architect and/or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on: / / t,�
Lot 5' ) Block / Subdivision !/U �- // �a�f g/ ® 1
Street and Number where work is to be done /037 .A1 _ / 7Z Z /
State work to be done and purpose of building by floors), state exterior colors (submit samples) PG%M0USGf(ON CA.R_ 19(:)+ l , aOUy�
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Rock Covering
Estimated Total cost of improvements S Amount of Permit S 4
Zone cubage required Plan Cubage k$ AS mivt4
Distance to next nearest building Size of Building Lot / i ' °
Maximum live load to be borne by each floor
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 . rmit; 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 a es ::.loy only s subcontr ctors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
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.
1 "' Date
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Permit No.
Disapproved
(Signed)
}SS.
O AJ( A
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
Date SPT 9 r 19
h
No. / 637 Street ,4/
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known.
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.
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