1192 NE 91 Terr (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address # /V b' / 'J / ! � ' - Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant ? k . [ 1 • r L. I tit ct LJ•e Master Permit # `10S y
Owner's Address $ C( •71 e. Phone 75i- oZ S Cf fy72 -.s°Z //
Contracting Co. nit/MA r`. Address
Qualifier SS# Phone
State # Municipal # Competency # z/ 19 pues walsam 11.61
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION P q; ' * N a (•( s l� / ' l' e3 ! 1 C n -IN- 2Ct IN G / 14 J
• / { - Inlet_
Square Ft. Estimated Cost (value& J" 4 "e
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
lows regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
ontractor
Signature of owner and/or Condo President Date
FEES: PERMIT '7// • RADON
er -Bui
igna
der
ate
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Notary as to Owner and/or Condo President Date Not aryy as to Contractor or Owner- Builder Date
My Commission Expires: My Commission Expires:
� C7
C.C.F. / G 4 NOTARY 1/45 BOND
TOTAL DUE
APPROVED:
Zoning Building 10/141,6 Electrical
g
Mechanical Plumbing Engineering
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 ordinance %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.
i
Owner's Name and Address » di i 10
Registered Architect and/or Engineer
Name and address of licensed contractor
Location �� / d egal scrip nooff lot to be built on:
Lot. /1 a 5F WL y G p Block
Street and Number where work is to be done
New Building Remodeling Addition
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
�.
C it 40e-
A /
Date S
S 19_51_ 1
No. 1 17 ( Street NE 4l Ie
Subdivision �'i! 41 � -40
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
1) 1 #- 01 2
and for no other purpose.
Repairs No of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S �10e d Amount of Permit S 7(156
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 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 re. • 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 pos or nspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agree y such su ctors, on ` 3t..e performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Si
STATE OF FLORIDA
COUNTY OF DADE. } ss.
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.
76477 Date 5
Permit No.
Disapproved
(Signed) -
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 525.00 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.
Date
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
3
MkTROPOUTAN O.0 COUNTY, FLAIUOA
•
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Your apvlication for Product Approv+�l .o! Portable` Utility Bu ldings
88
Lark Builders, !Inc.
P.O. Box 430
Wildwood, Fla.i32785.
•
OBPARfl1AstlY
• ' •* 1' '.Alal SOUTHEAST 1t3T AVENL10.1 :;!
.• �� • SAICKE..I. PLAZA t3UII.DING *' •
'*".• .• MtAb 1, Pl.ORIOA 33131°
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building Code governing the use of Alternate MateriaL; and.•1`ypas'•of ConstxuctiO4.1•N ;�11,
completely described !.n the plans, specifications • calculations I as submitted, by. «,40:..; ,.
Applicant.' along with plan No. 1 ).269 sheets 1 -8' and • 8A a ro ved' b 'Florida
Department of Community A airs Agency . :,• .:...t;. , ,. , .;
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,,,, :• .ii.,.; `,
has bow accepted by Product Control to be used Jet' • . 1J - iorporated arew o r.Dad4� ::"
County under the Specific Conditions sat forth at Page,'2 ,, ' ,�:; •, �-.7.;. 1 ' : 4,1,•: 0),!;. *. .1,' '
and the Standard Conditions on Page 3 ,
ACCEPTANCE Duo.:
84- 0315.1 (83)'
APPROVED
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TQAP Sr R l 4T A9S NcE
Product Control SuparvisOx'
M,ecropoLitan Dada County •':;` .
Building E. Zoning Department
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Are
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LEGAL DESCRIPTION:
The East 10.00 feet of Lot 23 and all of Lot 24, and
the Westerly 15.00 feet of Lot 25, of "WATERSEDGE ",
according to the Plat thereof, as recorded in Plat Book
9 at Page 141, of the Public Records of Dade County,
Florida. •
a /k /a 1192 N.E. 91st. Terr.
NOTES:
- Lands shown hereon were not abstracted for easements
and /or rights of way of record, except as shown on
recorded plat.
- There are no encroachments onto the property, except as
shown hereon, if any.
ANUCY,INc.
LAND SURVEYORS
4694 PALM AVENUE
HIALEAH. FLORIDA
33012
TELE 821- 1281 305- 821 -1220
SL/,P Vt
1 I•L12EBY CERTIFY THAT THIS PLAT OF SURVE
UNDER MY DIRECTION. THAT IT MEETS THE
N:CAL STANDARDS FOR LAND SURVEYING 1.
FLORIDA (CHAPTER. 21HH-6 FLORIDA ADMINt
FCR THE TYPE OF SURVEY SHOWN HEREON.
CORRECT 0 THE BEST OF MY KNOWLEC
COPIES HIS SURVEY ARE INVALID U
WITH TH L'QFJ U OER. tGNED.
r
State of Florida
J.H. Ma Professional Land Surveyor 11128
Robert B ••mster Jr.. Professional Land Surve;
Februar
Date: - -
/Zee,
50
Ito
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2\
c . s
2
26
N
/.�D Z/A/ .2
Are
/ //s �Qo6 /e
LEGAL DESCRIPTION:
The East 10.00 feet of Lot 23 and all of Lot 24, and
the Westerly 15.00 feet of Lot 25, of "WATERSEDGE ",
according to the Plat thereof, as recorded in Plat Book
9 at Page 141, of the Public Records of Dade County,
Florida. •
a /k /a 1192 N.E. 91st. Terr.
NOTES:
- Lands shown hereon were not abstracted for easements
and /or rights of way of record, except as shown on
recorded plat.
- There are no encroachments onto the property, except as
shown hereon, if any.
ANUCY,INc.
LAND SURVEYORS
4694 PALM AVENUE
HIALEAH. FLORIDA
33012
TELE 821- 1281 305- 821 -1220
SL/,P Vt
1 I•L12EBY CERTIFY THAT THIS PLAT OF SURVE
UNDER MY DIRECTION. THAT IT MEETS THE
N:CAL STANDARDS FOR LAND SURVEYING 1.
FLORIDA (CHAPTER. 21HH-6 FLORIDA ADMINt
FCR THE TYPE OF SURVEY SHOWN HEREON.
CORRECT 0 THE BEST OF MY KNOWLEC
COPIES HIS SURVEY ARE INVALID U
WITH TH L'QFJ U OER. tGNED.
r
State of Florida
J.H. Ma Professional Land Surveyor 11128
Robert B ••mster Jr.. Professional Land Surve;
Februar
Date: - -
/Zee,
S PREPARED
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