934 NE 91 Terr (2)Date //
Square Ft.
APPROVED:
Zoning
Mechanical
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address/ F31. NE ?/ Tax Folio
Legal Description
/ Tenan'REy Master Permit # 1 7 1 :C6,
Owner's Address S,' /lob AS f got)
Contracting Co/' OWN' t _ Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one):
WORK DESCRIPTION)/ R4//t/7 j - f CLE/4/J
s�9n�E n5 PRESEi Ir COGO,e - 5)001 /w,J Moo
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
FEES: PERMIT RADON C.C.F i
Historically Designated: Yes No
Address
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Estimated Cost (value)
Phone)< 305 7$K s'S
/ 36' 7o 6sooj7
2y
Dove ul/h / r6'
? P/9L/ti
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, C� . 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.
OWNERS 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.
Si
Building % ki
f Contractor or Owner- Builder
TOTAL DUE, ST
Date
Plumbing Structural Engineer
MIAMI SHORES VILLAGE 757 — 0/ 79'
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 Address
!� Street and Number where work is to be done
/
e (� Date # /1 19I
J J
3T oHid L, i1 /��'c5 �IC_•t`l No. / a 72 9/ ilAfil
Registered Architect and /or Engineer
77 f
Name and address of licensed contractor 3- 8 7/
Location and legal escription of t to be built on: c
Lot , , , 7% , -11; 7 f loc Subdivision 6 / 2 fiLia
vState work to be done and purpose of building (by floors), state exterior colors (submit samples)
and for no other purpose.
New Building Remodeling Addition Repairs
/�fo be constructed of Kind of foundation Roof Covering
timated Total cost of improvements S Ca Amount of Permit S
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 certi'y that he understands and accepts his obligatons as an employer of Labor under the Florida \Vorkmen'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 requiree by the Act. The undersigned agrees to emp J only such subco tractors, on ,, .rk to be performed
under this permit. as are licensed by Miami Shores Village. /
Remarks (Signed) d
e
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
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.
Disapproved
(Signed)
Building Inspector
c71- w
C
Date_ i
Date
/rg'
// Jaae At l',/ W
i9 /i , o v -5 ,e0e /- w /t)
No. of Stories
Read, Sworn to and Subscribed before me.
Notary Public. State of Florida
to me well known.
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 S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and.or workmanship.
Owner's Name and Address
Registered Architect and /or Engineer.....
Name and address of licensed contractor .�,oe A 4
Disapproved
(Signed) e`'�- wie
Building In ector
MIAMI SHORES VILLAGE
BUILDINC; 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. �p f
Date 7 19 G/
4 .�
Location and legal description of lot to be built on:
Lot Block Subdivision on/ B �-
Street and Number where work is to be done 95, , v' . 9t 7 c' ;3
State work 5y be done and purpose of building (by flo s) /� '� /t / /t �'� ✓ p" /•
n �L � �`�+s. e. �w A- � ,PA, iLt-
No.. --..
YI A d 5 a 44 47 . / £ 191<e
and for no other purpose.
New Building Remodeling _._ V Addition Repairs No. of Stories
To be constructed of 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 hcreby 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 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 agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed - �lT �l
STATE OF FLORIDA,
COUNTY OF DADE. 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 react the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No a 3 Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING 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 been 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.