1241 NE 91 Terr (10)Owner's Name and Address._
Registered Architect and /or Engineer
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 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.
Name and address of licensed contractor �- /
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done i , ,-,../7 l ' — ..-_�
State work to be done and purpose of building (by floors) » r
Date , 19
No Street
and for no other purpose.
New Building �; ._..,Rernodefing Addition Repairs No. of Stories
To be constructed or?" ` ' v " " - "Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
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 the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to f J
.. , �, , , : .
�
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup` ement,
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)
.ice
STATE OF FLORIDA, 1 ✓ _ -,7,-. COUNTY OF DADE. i ss.
Before me, the undersigned authority, a notary public, duly authorized 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 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 /(,.., Date Rea Sworn to and Subscribed before me.
Disapproved .1 Date
(Signed) �� % ' ' " t
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLAN NG BOARD DATE
Chairman Member
Member Member
Member ...__.. Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has heen obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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
Registered Architect and /or Engineer
Name and address of licensed contractor L/,1 7 09 - 4.9
Location and legal description
/
criptiioon of lot to be built on:
.g/ �f1K
Street and Number where work is to be done
State work to be done and purpose of building (by floors), state exterior colors (submit samples) A A((..& C /f /`r 7 - /'C J l • * /--/)
,e.,9,4- 94 s ' L 69/cid .t' "..5 "? c7t',c
% AcJ!) , T/ F7,tJ••
New Building Remodeling
To be constructed of 67.c1AS7"9 4 - 4 " . " i‘.t'e-- Kind of foundation
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Subdivision
� 2 /
,a t j'
Permit No.
Disapproved Date
(Signed)
Building Inspector
and for no other purpose.
Addition Repairs No. of Stories
mot/ /7
c''r,
Date 19 c '
No. ‘ " e / Street /6
Roof Covering
cam?
Estimated Total cost of improvements S _ 1.0 °7cx Amount of Permit $
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 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 inspect ion
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su contractors. on work to be performed
under this permit. as are licensed by Miami Shores Village. >
Remarks ISignedr
Date 047 /if Read, Sworn to and Subscribed before me.
es- e gk87
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 -
7'''
and who, being by me first duly sworn, upon oath deposes and says that he is the C Ai ( . 7 - 7 0 L -
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.
Notary Public, State of Florida
My Commission Expires
to me well known.
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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and.or workmanship.
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
CITY HALL 'OF ( OWNER TO RETAIN COPY) jignimange, MIAMI SHORES.
Date JULY 24,19,b Address / )_ y /
Legal Description, (r4 fi 6' 3 / cie ` 1 , Master Permit. . ,1 / 57 r
€4;:er%1 Lessee / Tenant
Owner's Address
Contracting Co.
Qualifier SEYI"OUR GGPHEI$ ( CBC 9454)
State#
CBC 9454
Architect /Engineer
Bonding Company
Mortgagor
Square Ft. 45.74
�G %�/ ,✓� r 9 / j;41 MIAMI SHORES
SECURITY WINDOWS /SEYMOUR GOTHELF CBC 9454
Address 5100
vil e/
/
Competency 1
SS#
Address
Address
Address
Estimated Cost
Phone
N , "7
Tax Folio /1-- 14, f mac, / er t;p.
3
379 -0304
N.W. 72 AVE. MTWT, FTA 11166
Phone
Ins. Co.
591 -8990
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION REPLACING 4 ATW WITH 4 AYW IN EXISTING OPENINGS, NO STRUCTURAL CHANGES.
665.00
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
will be done in compliance with all applicable laws
Furthermore, I authorize the above -named contractor to •• the work stated.
eA
Signature of Owner and /or Condo President
Date: 1,11i.k
Notary as to Owner and /or Condo President„
My Commission Expires: L H
*HI!
PERMIT FEE: APPROVED:
Zoning
Mechanical
Psi 'S /99
Fire
regulating construction and
q t
Building ~�, / \ Electrical
Plumbing Engineering
Signature of Co tractor
/ Date:
uqr„e= J JC-
Notary as to Contractor or Own
My Commission * pires,
Other `
or Gwne Boil
all work
zoning.
r :gilder
!ATC FLOR:rA*
therein by him stated are true.
Permit No..___
Disapproved A ��
(Signed)
Buildin
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 Budding 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.. .._...___._. .:._._ ,19...%
Owner's Name and Address ....J RI) £ .1..LI I -; ._ No treet 1 _ EAR
R
Date
pector
Registered Architect and /or Engineer 1
Name and address of licensed contractor _..—
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done _._.. ..y l .. 4/ t L _c. .. L._ — <- ..L ..,c
St purpose of building (by floors)
a work to be
� '.. done and pu `? o..► J P FA-2.E _ _..... 0A - R ...�
PP'' Ro - .-.f�.i 4 _ Q.... -. O J and fo r no other purpose.
1 � r �- >�- p r1� ' .
New Building Remodeling Addition Repairs ` No. of Stories
Date.. 1
L /-_,. 0 „R ! 1.111..,_
PLANN11l(C BOARD
Notary Public, State of Florida
DATE
Roof Covering
To be constructed of Kind of foundation
ti ,
Estimated Total cost of improvements $ . �:.. �- Amount of Permit &
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 the 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 obligations as an empoyer
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 bin:
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 subcontra / rs, on work to be perfo.-mea nder this
permit, as are licensed by Miami Shores Village. . )� _
Remarks ( Signed )1111_ ... .
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
--- Commission Expires
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
a Read; Sworn to and Subscribed before sae.
Chairman r y Member
Member Member
Member 1111.. _ 111:1_ - -- -11_11._. _..._._....... Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has herr. abtained from
the Planning hoard.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for ins ectinn or faulty
materials anti /or workmanship.