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ROOFING
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 2-3 Job Address ?/),:' 9/4 Tax Folio // g /P/ / 9 " ' Master Permit # w - 7 Legal Descriptionl4S Z .14 Owner / Lessee / Tenant A//q n Owner's Address. •%" Contracting Co..4Cal,ULL0f,` k4 L1' Lek S Address 94.- - Qualifier ) / 4 A • a + 4, L, LI ( L . 5 SS# Phone 5 9 „ 5 - - - r - z State _— L. Ct1r- unicipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address 3$1017 D 41'f Mortgagor 4117rrf r . Address ? (). jj y 9 (I fi)t 2.4octrc2 Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ” f66 Lam/ r1/ e di' `r( 07 � Lf -1,6 EVA " , . ( 7 : ' ' t � > ` " ' � C ( LJ/ LW- L dam! .o r i ¢3 a fat fi 6©(r((z 0 7 Dt`TU -4r1/41 \ I y Square Ft. Z Estimated Cost(value) t ZC f 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 zp ng. F thermore, I authorize the above -named contractor to do the work state APPROVED: Notary as to Owner and /or Condo President My Commission Expires: Date: tt0T P'1R'.1 `' STb 0 E� ?^,\ ** * * , ; *: _ * • L').* * * * * FEES: PERMIT rae l Qe RADON C.C.F./P NOTARY TOTAL DUE * 40 Fire � Other Zoning Building„`� 't�Electrical Mechanical Plumbing_ Engineering Signature of Contractor or 9rner- Builde tar, dici„ Notary as to Contractor or Owner- Builder My Commission Expires: P'sLIC 3 ^... p^ rLosTrn ..,. U.U. PERM I To TAX FOLIO NO./J J /D/' /9 X 0.70. 6 State of F l o r i d a County of Dade NOTICE OF COMMENCEMENT , 2R486559 1992 DEC 11 15:22 THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided In this Notice of Commencement. 1. Description of property:(legal description of the property, and street address I f ava l I ab l e) .E S • 3 2. General description of improvement: KW/ACL /rpc 3. Owner I n format I on : ' Sft12`- a. Name and Address: OR AA.) Q �/\,P�,rc�,2� T Sco'r - r Izo A1� 9( S . 33133 b . Interest I n property : ow �✓L- c. Name and address of fee simple titleholder (If other than owner): 0 fl`'7Zre_44t- T ( Pk%).4 I� 4. Contractor: (name and address) A-QGt I.t6C4.,.l 2Gti v4zl. l (--1. 5. Surety: a. Name and Address WA b. Amount of bond $ /f//Q • 6. Lender:(Name and address) Al 7. Persons with the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes : (Name and address) ZOE . f' ?N./L. 8 . I n a d d i t i o n to h ims 1 f , Owner designates lac t. of 142):›‘ ICE to receive a copy of the L I enor ' s Notice as provided In Section 7.13.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a different date Is specified) Sworn to and subscribed before me this Notary Public STATE O° FLORIDA COUNTY OF DADE HEREBY CERTIFY that this Is 7331 64 nt O oril R filyd In this office on 4 ay o4 A. D. flQ WITNESS my and and Official Seal. Clerk Circuit Court DC `4C,C Br` 3 ' Signatur- •f Owner fiffrA PU3LIC STOP 1'CP In 199 / COVIMISSIOli El,P. NOV.20,1993 BOHED TIRRU GENERAL 1'idS. LriD. May Commission Expires /// & /y3 MIAMI SHORES HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS 1. NAME OF PROPERTY: a lc.Q{ -e S - 1 73 Sv DATE: 1 (� pp , n/ z - '1 2. ADDRESS Iz-c> NE 9 1 SSA VJl i I•wti. , SM -S . 33138 LEGAL DESC. L 'S / a 3, 4 4" - 3UL 7 £ Set . Z 3. NAME OF OWNER & ADDRESS : I.A. 12-6 S ��- 12.6 Ft) ( St v viz h .Stt-isS , ii. 33 13$ 4. NAME OF APPLICANT & RELATIONSHIP TO OWNER: h -tM_� ,1L . - 5. PRESENT USE AND CONDITION: OW N I• -- - .' . d-- • C 4'1%c/) I.;4 eat c. — 1 i N o f s 1 6. TYPE OF PROJECT: (circle one or add unlisted project- (J. OTHER) MAINTENANCE OR REPAIR B. RESTORATION C. REHABILITATION D. ALTERATION E. ADDITION F. EXCAVATION G. DEMOLITION H. NEW CONSTRUCTION I. RELOCATION J. OTHER (EXPLAIN) 7. IS A ZONING VARIANCE REQUIRED FOR THIS PROJECT? Aro 8. DESCRIPTION OF PROPOSED PROJECT, INCLUDING WHAT CHANGES WILL BE MADE AND HOW THEY WILL BE ACCOMPLISHED. R t �3i� - t - t --t) t —Q_5 b e 4,\ (.:6,04-Alge A ) Qtr-/ APPROVED; 9. IF USE OF THE PROPERTY WILL CHANGE AS A RESULT OF THE PROPOSED WORK, EXPLAIN THE IMPACT OF THE CHANGE. A, PA- The Board shall be supplied with copies of the Original Designation Report filed when the property was designated as a Historic Landmark and copies of any Certificates of Appropriateness granted previously for this site. / w > CHAIRMAN. L* o cY ,n t3' ' MIAMI SHORES HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS 1. NAME OF PROPERTY: &r 2. ADDRESS 1-2-A› N6 `� ( S. - tkk �...�: 4-e_ . .33138 LEGAL DESC. L ;25 / a 3 , T31k- 7 £ ( Pad- -# . St^t . 3. NAME OF OWNER & ADDRESS: C�(L.i /�," �" 1A,,at-P4 "X,�T S c.o-R- I 2 ,v6 t St- Utz, Ac .St4.2S , (, 33 3$ i 4. NAME OF APPLICANT & RELATIONSHIP TO OWNER: Te?IyitA04 itt Setc - 4 11 (2,. DATE: z — y - q Z ID iT n &e s.;17.« a� 5. PRESENT USE AND CONDITION: 3 w Ai 2�rzra I ��,,,� .0 n o•z•s '�J 9 fire - O-' 6. TYPE OF PROJECT: (circle one or add unlisted project- (J. OTHER) MAINTENANCE OR REPAIR B. RESTORATION C. REHABILITATION D. • ALTERATION E. ADDITION F. EXCAVATION G. DEMOLITION H. NEW CONSTRUCTION I. RELOCATION J. OTHER (EXPLAIN) L . 7. IS A ZONING_ VARIANCE REQUIRED FOR THIS PROJECT? A ro 8. DESCRIPTION OF PROPOSED PROJECT, INCLUDING•WHAT CHANGES WILL BE MADE AND HOW THEY WILL BE ACCOMPLISHED. Rt r2a� -rte esf ►�..��,.; , dA. c_,N (f&LA ) W-fr 9. IF USE OF THE PROPERTY WILL CHANGE AS A RESULT OF THE PROPOSED WORK, EXPLAIN THE IMPACT OF THE CHANGE. n■ � The Board shall be supplied with copies of the Original Designation Report filed when the property was designated as a Historic Landmark and copies of any Certificates of Appropriateness granted previously for this site. APPROVED: L CHAIRMAN Waxier) % . / • Application is hereby wade for the approval of the detailed statement nt ur me 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. O R1 S E Date..._ _Oar _.... a i..SL.o Owner's Name and Address . oibE1ZT ..... _No../ck0 .. Street.,t. C/ .57` / Registered Architect and /or Engineer. .. . ................. „, Name and address of licensed contactor _.. arson and legal description of lot to be built on: K 2s' ikr 1—. as. .. 4 Lf Block - 1 Su hvisionE I O A l.. . _.li d _ Z' Street and Number where work is to be done ! 2-0 _.!” • e t_ — .._..__ '� - S ate work to be done and purpose of building (by floors) - ..E.�I- -Pie -d C�4 1 L I �G 1r�n _m3, -0t. b C.E NG - M _ 'D12. . t New Building To be constructed of Estimate Total cost APPLICATION FOR BUILDING PERMIT Remodeling Kim of of improvements $ ("/ 0—¢1) . 00 Zone cubage required Distance to next nearest building STATE OF FLORIDA, COUNTY OF DADE. ss. Bcfore me, the undersigned authority, peared Disapproved (� Date (Signed) X!I!Y Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT and for no other purpose. Addition Repairs No. of Stories .t foundation....... :... , Roof Covering...g. V.E..L..._..__ Amount of Permit S. Plan Cubage S 7 Size of Building Lot / V 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 per:nit 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 Sop i le•ment, anti has complied ■sith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in tkc 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed)...._(e '14. a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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 e. Permit No.._. 4 1 _ Date 0 ) Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires •• ........ •••• PLANNING BOARD DATE Chairman Member Member Member ,icmbcr Member ...._ _- ._..... Council Approved Date Disapproved Date NOTE: A c•h.rrge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the I'Lrnnir.g fo.■rd. A re Ice of $1.00 will be charged when such re inspection is made necessary by Improper notice for inspectitm or faulty materials and /or workmanship. 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. Date CR 4961 Owner's Name and Address....MC�C�C.._ No Street. LS Registered Architect and /or Engineer... _ _ Name and address of licensed contractor_. _ C� Q -_ __..._ --__ _-60.0..__ �.IJLa___- _C_.S Location and legal description of lot to be built on: 1 Lot.. Block______ ______ _______ ___ Subdivision Street and Number where work is to be done - ...( .. Ni_ _I Si... State work to be done and purposp of ilding (by floors) ` EZIVC c- G_Lit_ is and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering__- ...._ .__. Estimated Total cost of improvements $ OC) 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 foi said building. All notices with reference to the building and its construction may be sent to__ The undersigned applicant for this building permit dot 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, Pennanent 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) STATE OF FLORIDA, COUNTY OF DADE. 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 7 ted are true. Permit No Disapproved (Signed) ® Chairman Member Member . Council Approved ss. Date..._ I--_-__- Read, Sworn to and Subscribed before me. Notary Public, State of Florida \ czo,mA ja\\LateD cau, Building Inspector My Commission Expires__ - .- PLA G BOARD __ . __ DATE Member Member Member 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. 0 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Al Architect Contractor 1 or Builder t,. ' Legal Lot Description Address of Building ' 1 c l CONTRACti'OR or BUILDER MIAMI SHORES VILLAGE, FLORIDA Date �i 19 PERMIT N° 11 11 1 BI. Lt r / 9003 Work to be performed under this Permit _e. 7 Subdi- vision Sq Ft Value of il c' Project $ BY Contractor's License No. C' t - * a Amount of Permit $ BY AUTHORITY T -- 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 an ■ plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be 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 '10 perform the work covered hereunder in compliance with all ordinances and regulation, pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work ddne by either, myself, my agent, servant or employee. r. , MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR - BUILDING PERMIT Application is hereby made for the approyal 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. /J p Date .� , i': v ... ii, , 19 Owner's Name and Address r'• o No � Street Registered Architect and /or Engineer 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 - a State work to be done and purpose of building (by floors) - and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ , _L::_ 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 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 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 subcontrac ors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) t r -0_// 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 read the foregoing application, and that he did sign the same, and that all facts therein by him ted are true. �✓ �' �_ A Permit. No ` � Date Qc ' ° ( Read, Sworn to and Subscribed before me. Disapproved (Signed) , - _�. ._._... .fi�.� , r� Building Inspectp' My 't•;± fission Expires LANNINC BOARD DATE Member Member Member Chairman Member Member - ...... Date._ Notary Public, State of Florida 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. x-413 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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. Date 1./ " ,19.x..._ Sr Owner's Name and Address._ .. NP 4HI ,__.., ?�t91 ' _ _ ,/ �-e No.. __,t, 0 Street_ 9/ I- Registered Architect and /or Engineer........._..0 . te.x}_e%� 1"/_7 Name and address of licensed contractor 4../.4E2. 7- 20.53 iv .c. Za/Z 4(,Ii-J.-. /.7�f....- -......... Location and legal description of lot to be built on: I Lot ,Y''' ,' . < /`C 1 ` 4 Al Y Subdivision.. /...f. ✓.. a.L_ ...:.-2 " 3 ...»�l'�' des / Street and Number where work is to be done /2.0 ice� / 4t. '7l .S tf7.4 — State work to be dune and purpose of building (by floors) L2W.E Dl' y / ./2: i 4F• .4.e.!,Q iy,F (a,...._i2Oox eV iticeir dc.u.E.4 end for no other purpose. New ::in_i'ding Remodeling ./ Addition 1,e''' Repairs No. of Stories To b. constructed of C4.5 Kind of foundation.. 1v"4_./.6 „ 6. r° ire • Roof Covering 7; 2 - e:- Estimated Total cost of improvements $ ,,_ /T O, 6-4) Amount of Permit $ I6) . (-- ' � r ;� - � � _ Zone cubage required Plan Cubage � ( .°_, ... r. 1. "' l '= /._� >..�/.) — DIstance to next nearest building oz.- Size of Building Lot fe.c ' -3 ' °, Maximum live load to be borne by each floor n ■ I hereby submit a the plans and K AC.S. s� for said building. All notices with reference to the building and its construction may be sent to .lbc.L.° _. Y,/.___ ,CL.7__c_ �.'y..2L1 ,a /1.9 74 7 , 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 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 subcont ctors, on worJE to beTerformed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, 1 ,._.7 . COUNTY OF DADE. J 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 C / 1 ‘ 2.`D Date / � 57' s Read, Sworn to and Subscribed before me. Disapproved (Signed) •• Y � r��i'.- Building , Spector / PLANNING BOARD DATE Chairman Member Member Member Member ..__ Member Notary Public, State of Florida My Commission Expires 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. ko ••• S • r t k ) ' / • I 7,5 1 ( MIAMI SHORES VILLAGE. FLORIDA ";UILDING ❑ -= LECTRICAL DATE // t 195 ❑ PERMIT N? 7 213 Contractor's License No. ; t.. ;IOOFING 0 ❑ Work to be performed under this Permit i ' :' +""" * , Owner of wilding r .egal Lot Description R � � Address of / l l 1 uilding CONTRACTOR OR BUILDER 1 n rchitect - jontractor Dr Builder B1 Subdi- vision Value of —` Amount of t. Project $ = I� Permit $ This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application nerefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans lrawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be 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 responsibility for work lone by his agents, servants or employees. f - f r 4 Signed •, BY 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- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 7 Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contracto - �i Location and legal description of lot to be built on: Lot Block Subdivision 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. Street and Number where work is to be done Stajk t• °be done and purpose of building (by fors) New . uilding i(0- . - -... Rernodeling. Addition Repairs and for no other purpose. No. of S ies 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 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 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 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 i • ection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such ontractors, o• o to be per med under this permit, as are licensed by Miami Shores Village. Remarks ( Sign Disapproved Gam(. (Signed) Building I : ector 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 and who, being by me first duly sworn, upon oath deposes and s that he is the. of the above described construction, that he has carefully read a foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No 7 Date to me well known, 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ❑ ELECTRICAL ❑ DATE 195 PLUMBING ❑ PERMIT N? 9766 ROOFING ❑ ❑ Work to be performed under this Permit— Owner of Building Architect ontractor _Dr Builder .egal )escription 4ddress of ; uilding Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Bl. Subdi- vision Sq. Ft Value of Project $ Contractor's License No 4 Amt. of 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 application ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, irawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any _ime 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 ,ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work gone by his agents, servants or employees. Signed • BY 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY I7 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. Date , 19 Owner's Name and Address • 6 Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot ti Block Subdivision Street and Number where work is to be done J 9-6 E No Street o j 5 7 1 l Read, Sworn to and Subscribed before me. State work to be done and purpose of building (by floors) (} �, and for no other purpose. New Building Remodeling `� "'� ii' Addition Repairs No. of Stories To be constructed of Kind f foundation..... Roof Covering Ue Estimated Total cost of improvements $__.. ' ... i 9 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 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 s bc• _. tors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 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. ry 'c�C� Permit No � / Date ' ' Disapproved Date '� i�� Notary Public, State of Florida (Signed) (-) , .>,.. Building Inspector 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.