9301 NE 9 Pl (2)4
MIAMI SHORES VILLAGE
STATE OF FLORIDA
COUNTY OF DADE.
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
o �
Owner's Name and Address t� ll / te
No. L ,l Stre" / _
Registered Architect and/or Engineer
Name and address of licensed contractor
Location l ann n d 1eegal,c�pc,�p n of)g e built on:
Lot N- /W 4 -b Block Subdivision
Street and Number where work is to be done V/ ✓�
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
�'� �ff /rum 7� �� ����- and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
cps
Estimated Total cost of improvements S t 1� "lJ Amount of Permit S ! 06
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 com. ' with the pr. ' 'ons thereof, and will require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed under t ' per ' : and . ' i post 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 agr toe + oy� such s :contractors. on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
J ss.
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, and that he did sign the same, and that all facts therein by him stated are true.
Permit No. zi=0 ` ru Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
ACW
Building Inspector
Date
(f q3 S
5i0S m7 eself
t- J
Notary Public, State of Florida
19
My Commission Expires
to me well known.
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved 1 ate 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 525.00 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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Cons.
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THESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS"
E MIA :'.1! vflRES BUILDING AND ZONING
UNLE.; SPECIFICALLY LISTED BELOW.
AND COUNTY LAWS MUST BE COMPLIED
Aunori'ed Signature Date
• WITH NO VARIANCES ❑ WITH
NO OTHER DEVIATIO::S FROM T
ORDINANCES WILL DE PEd.71TTED.
ALL OTHER APP! ICAB'.E STATE
WITH BY ALL PARTIES.
FIRE DEPARTMENT
PUBLIC NORXS
POLICE DEPARTI,IEi;T
BUILDING DIRECTOR
t 1 '
PLANNING & ZNI :G ;;.O....:
VILLAGE COUNCIL
APPROVAL
PRELIMINARY: FINALo
REMARKS:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER &
SUB CONTRACTORS ARE r:'' ;r -''17" ' "" K''.OV'LEDGE OF ALI BUILD.
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 9301 NE 9 PL Tax Folio
Legal Description lu ILO." E 128. -cT E PST °G Historically Designated: Y s No
Owner/Lessee / Tenant Luu do 814 n(CALa3 At /rp, P 4) &,v5 T Master Permit # (" 2 6 2 ti. ` . -S
Owner's Address 93 01 N a 9 PL-AGl=
Contracting Co. nu WO rg.JC( OG G(,0, .4 4 Address 35 S — CAI 02 S t
Qualifier P I aa d o LO e2—
State #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Z 4g S ". ./14 I I Ca S 0 4 '4‘14
J
` 3o / t,L)660
Square Ft 5 y3 1` - .•P
Signature of owner and/or Co ... 'resident Date
Notary as
My Co
APPROVED:
Zoning
Mechanical
wner and/or Condo President Date
ssion Expires:
FEES: PERMIT 6/9-
RADON
Building
C.C.F. g ° 9
Phone 3 4 )5 - 59 1 ° 0/
SS# Phone a o5 - t88-gORO
Municipal # 92%65 01.4? Competency # 98 !35 00 a (1) Ins. Co.
Address
Address
Address
Estimated Cost (value) / 3 6,06 o G
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 one in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named tractor to do the or, stated.
Signature of Contractor •' Own - Builder
Notary as to C
My Commissi
n
NOTARY
tractor or Owner - Builder Date
Expires:
, ' I VELYi t. Pk k. `
04 l•
.:: MY CDMMf3S10N v CC r.:340t
I roe Sanded EXPIRES: Januoy 2, 20c2
Am Notary PubUC tnvritats
Electrical
3/3/”
Date
/ 0/0/9?
Plumbing Engineering