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1130 NE 91 Terr (4)• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date i' Job Address 1%50 lj El 51 - 171(ra,c4L . Tax Folio %11- 3a © --- Z •-. C‘k n Legal Description Owner / Lessee / Tenant ?)(arck7 (7:77; i Master Permit # , Owner's' Address 1 1 30 ,6 1 - Phone '15 Contracting Co. y Commission Expires: ** * APPROVED: Zoning D ' Address 1 Q'S 2 S • b NC_ (2c Qualifier _l - oni SS# Phone 6;2 -- State #(00 Municipal # Competency 9i InS.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING EL ECTRICAALPLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �� o _ c. S . S��✓� co tiP p LA /I' 1 G*i,! ji 63ANET M. GRAHAM N %` ary as to •weer and /or *rj . PillifidideJ O � D co.o Square Ft. EstimatedCost(value)- 9G 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. ea ig tune of o ier a ;, or Condo President Da or or Owner - Builder n r,.;; s T M. G A�iAM PAMMISSI h CC235639 ary as to Contractor or Owner- Builder My Commission Expires: * * * * * * * * * * * * * ** FEES: PERMITIPW'4eW RADON C.C.F. 0 NOTARY TOTAL DUE a ' u o Fire Other Building Electrica :` AAe Mechanical Plumbing Engineering 4 BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor or Builder Legal Lot Description Address of 3uilding n n Owner of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT x9 5802 Work to he performed under this Permit B1 DATE_ 19- Contractor's License No. Subdi- vision Value of 1; Amount of Project S II 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 he 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• ceptinq this permit I assum:: responsibility for all work dons by either, myself, my agent, servant or employed. BY AUTHOR :7Y .ROT Vii.. MIAMI SHORES VILLAGE, FLA. N? 6146 • • 4 :4 //' JOB.'/ C ADDRESS id INSPECTION (Z, TIME READY . REMARKS : INSPECTOR /A, el_ DATE Permit No Amount of Permit $.. STATE OF FLORILA, } COUNTY OF DADE. ss. M AM1 SHORES VJLLAGE ELECTROC L IINSP CTIIO 1 DEPARTMENT I[ NT AFFLMATllo f fry ELEC ' HMAL I CG MO7 Application is hereby made fo- the approval of the detailed statement of the p .ns and specifications ,zer::with submitted for the building or other structure herein described. This application is made in complia and conformity with the Building Ordinance of Miami Shores Village, Flo.'da, and all.,ro of the Laws of the State of Flori a all ordinances Miami Shores Village and all :ules and regulations of the Building Division of Miami Shoe„ Village shall be complied with, v.•he:her he_ein speci;ied or not. A copy of approved plans and specifications must be kept at building during • rog•ess of woe:-. Owner's Name and Address. - tZu ��J .... ° `� elz No �Q Registered Architect :d /or Engineer - ..... Employing Electricians Name No Street Location and Legal Description Lot Block Street and Number where work is to be performed— No. 0 30.. .._... .Subdivision Street. State work to be performed and purpose of building (By Floors)..0V.Z. _ New Building Remodeling..... - ...... Addition Repairs............_ - .. ..- ......_.No. of Stones Service Overhead Size Feede -s .Co duct. . _ ..Main Sw Underg* :nd Type Installation — Conduit. .T big- . .. .B.X L . . .Metal Moulding. (Signed) The undersigned - pplicani or thic building pe it doe. hereby ce• tify that he understands and labor under the lo.ida W:,rkmen s Compensation Act, being Section 5966, Compiled General Laws has complied c tth the provisions thereof and will require simiia- compliance from all contractors or work to be performed under this permit; and will post of cause to be posted for inspection on the site as are required b: the Act The undersigned agrees to cinplo "i only such sub- contractors, on ork to licensed by Miam' Shores "illage. . Amps ......... D te..../0o Street C O..( ..Main -uses. ........ . .....Amps El cer..al Inspector -ptts his obl.gati..ns as an employer of Florida P.rmanent Supple- ent anJ subcontractors employed by him in the of the work sue.: public notice or notices be terformed under this perms+:, as a e Master Electrician. 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 constru tion, a .d he ha ' ca,efully read the foregoin • 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 UGH' OUYLEm PLUG REC.'P'T's ' IXTIIIIES N. O. LAMPS REFRIG. Ot'TL: IRON OUTLET RANCE OUTLET RANG'. CUNN. WAT':R HEAT :R ' Hr,'". CONN. Sr m'A HE ER STRIP HEAVE :' ' TOTAL C T S 4 1 CH C:t - ENT. rI DIM. S ". LP B. - E(V : E P. SERVii P RM �O:O O.1 HP TORS 1 -S HP . v ? is! TRANr. RADIO TOTAL CO.: - LI= � p.. ir - 0,/ a CHC Ii Permit No Amount of Permit $.. STATE OF FLORILA, } COUNTY OF DADE. ss. M AM1 SHORES VJLLAGE ELECTROC L IINSP CTIIO 1 DEPARTMENT I[ NT AFFLMATllo f fry ELEC ' HMAL I CG MO7 Application is hereby made fo- the approval of the detailed statement of the p .ns and specifications ,zer::with submitted for the building or other structure herein described. This application is made in complia and conformity with the Building Ordinance of Miami Shores Village, Flo.'da, and all.,ro of the Laws of the State of Flori a all ordinances Miami Shores Village and all :ules and regulations of the Building Division of Miami Shoe„ Village shall be complied with, v.•he:her he_ein speci;ied or not. A copy of approved plans and specifications must be kept at building during • rog•ess of woe:-. Owner's Name and Address. - tZu ��J .... ° `� elz No �Q Registered Architect :d /or Engineer - ..... Employing Electricians Name No Street Location and Legal Description Lot Block Street and Number where work is to be performed— No. 0 30.. .._... .Subdivision Street. State work to be performed and purpose of building (By Floors)..0V.Z. _ New Building Remodeling..... - ...... Addition Repairs............_ - .. ..- ......_.No. of Stones Service Overhead Size Feede -s .Co duct. . _ ..Main Sw Underg* :nd Type Installation — Conduit. .T big- . .. .B.X L . . .Metal Moulding. (Signed) The undersigned - pplicani or thic building pe it doe. hereby ce• tify that he understands and labor under the lo.ida W:,rkmen s Compensation Act, being Section 5966, Compiled General Laws has complied c tth the provisions thereof and will require simiia- compliance from all contractors or work to be performed under this permit; and will post of cause to be posted for inspection on the site as are required b: the Act The undersigned agrees to cinplo "i only such sub- contractors, on ork to licensed by Miam' Shores "illage. . Amps ......... D te..../0o Street C O..( ..Main -uses. ........ . .....Amps El cer..al Inspector -ptts his obl.gati..ns as an employer of Florida P.rmanent Supple- ent anJ subcontractors employed by him in the of the work sue.: public notice or notices be terformed under this perms+:, as a e Master Electrician. 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 constru tion, a .d he ha ' ca,efully read the foregoin • 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.