MECHANICAL PERMITSDate `- - - P / / Job Address i17 k 3 /7el'/ - Tax Folio
Legal Description
Owner / Lessee / Tenant 004 d/
Owner's Address ) � r/%i
Contracting Co. Ai a iieda e ,J& Address -. 7 1
∎ Phone
State # C J , WO :.5 Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(cirrcle one): BUILDING ELECTRICAL PLUMBING 4MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION � aw� Yoe '/� 4,6;(' �� ,
i,G,�.f�0; r ltd fy! ,./Ae
Square Ft. Estimated Cost(value) 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 const ctiop and zoning. Furthermore, I
authorize the above fiaud contractor to do the work stated.
wner an
GO o
- 1 gtiature f Contractor or
Date:
IRINA CONIODUO
1Notcry pub2c'Stot3 of Florida
My Comrni =ion `vrirc
21. 1995
* ccuab3B *
■
6
otary as to Contrac or
My Co
1
Signature of
Date:
Notary as to Owner and /o
My Commission Expires: •,
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE .
Mechanical
/or Condo President
** * * * *
/ / 7 - -;
FEES: PERMIT /' - RADON C.C.P.
N
Master Permit #
Phone d✓ d °
0 ®1/y'
9 •��
'•r
•�
IT - `,,l'APLETON
MY COMM!SS[JN CC 1E15200
EXPIRES: RIZ! 10, 1:,33
BotXraii Not .ryit+lYd: Und:rw tors
NOTARY TOTAL DUE
;
- d
•
e.r- Builder
or Owner-Builder
* **
Fire Other
Building Electrical
VO Engineering
e
WEZvLO EL-1 a MC E MO
05MG cM .SP .7C720M DEPN TMMVT
,AFPL TOWN FUR R-1131: PEMMO7
Application is hereby made for the c of the detailed statement of the plans aatd1 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.
Owner's Name and Address._.. l ' .. e� Sd1 - -- �S �o
!Registered Architect and /or Engineer.
Name and address of licensed contractor___ ,J 4° Ay K_ a ±1.. AP a - ; : ' o
Location and legal description of lot to be built on:
Lot.. Block Subdivision_
Street and Number where work is to be done -Cc/ _ S-77 pp � �
State work to bed a and purpose of building (by floors) _ _,____fL_._ Li71_,/
t,)(1 7 /1 0 z' c 44
and for no other purpose.
New Building Remodeling ___ Addition Repairs No. of Stories
To he constructed of Kind of foundation Roof Covering__
Amount of Permit $
plan Cubage_ _.
Size of Building Lot ____
Estimated Total cost of improvements $ Si) '
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor___
I hereby submit all the plans and specification for said building. All notices with reference to the building and its construction may
be sent to ! '� n G' '� 1 �� .. � �� ��� � e v �'
STATE OF FLORIDA,
COUNTY OF DADE. ss.
peered
Permit No
Disapproved
(Signed)
Chairman .
Member -- .-- -.__ -- __ --
Member
Council Approved
L
Date , I94
-- ---- -- No
Street
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, 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, wg�'� to - performed under this
permit, as are licensed by Miami Shores Village. j
Remarks-- -- - - - - -- - (Signed) - °-U ct
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
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
Date. ._ / ' / i Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building nspector My Commission Expires
to me well known,
PLANNING 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 1 -'" obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by imprope- ' jor ins an or faulty
materials and /or workmanship.
Street and Number where work is to be done
MI 1 G
Disapproved Date
a
QppL,��• �0 G�
Fun PE MATT
]Registered Architect and /or Engineer
Name and address of licensed contractor__ lfi (32'1
Location and legal description of lot to be built on:
Lot_ - Block Subdivision
t�� -mow c 0
Application is hereby made for the r of the detailed statement of the plans and specifications herewith submitted for the buiCd-
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.
/ 0:47:), -, gyp strew �' 0
Owner's Name and Address ' J
y -
pp
�. _ u__
State work to be done and urpose 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 $ / Ce
Zone cubage required
Distance to next nearest building._. ___ _ _ ___ _
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said bu' ing. All notices with reference to the building and its construction may
be sent to_ /fa z?f - kit __ a CO L1 P� f _ 9.s-7/44v if
The undersigned applicant for this building permit dots 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 tpr' to b` ,performed under this
permit, as are licensed by Miami Shores Village.
Remarks - -- - - --
Amount of Permit $
_Plan Cubage__ _.
Size of Building Lot
( Signed).
*":.4
(Signed) i =� - ` . -'�- ---- - ..
Building I,itpector
%/
PLANNING BOARD_- -- - _DATE
Chainnan / Member
Member - - - -- - Member
Member . _ - _ -- -- _ - Member
Council Approved Date Disapproved
Notary Public, State of Florida
My Commission E x p i r e s
Date_ -- ` i ` 1 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 read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No f 7i � ? ____ _______ _ Date_ Read, Sworn to and Subscribed before me.
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hr'er obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper nc. . tor ins_ . ton or faulty
materials and /or workmanship.