ROOFINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /0/4/ 9Z Job Address /0 7 3 n1 E 9Z
Legal Description /kl Z /a F
Owner / Lessee / Tenant YZ'l t c - A e ( C/ o LI U
Owner's Address /2 7: &)g / Z —
Contracting Co. (2.-.tc
Qualifieo-)■'-o
State #e6e oZBSS() Municipal 0 Competency 0 Ins.Co. us F G
Architect /Engineer A) ( d1 Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION F s .+ c.1- (.s
Square Ft.
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 d that all work will
be done in compliance with all applicable laws regulating construction and •• i L -. Furthermore, I
authorize the above -named contractor to do the work
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Signature of owner and /or Condo President
Date: `0 - 2 i3-- 40P
o Owner and /or Condo President
y Co ion Expires: L`,114hE
NOTARY PUBLIC STATE OF FCORIITQ.
** * E Ny. COMMISSION U OTA
E RY P PU*LIC UNNDER1*RI ERS,
APPROVED:
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FEES: PERMITI.44 / 8 RADON C.C.F.
Fire
Estimated Cost(value) 67 ZOO
_ y Commission E 417=I name of Norary pu�bjic
OR Prcduced LD.(]Cl
Type .end i) • produced:
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Master Permit 0 ) Lt
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❑ DID take an oath, or
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NOTARY -S . n O TOTAL ��
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Other
Buil:in �C Electrical
Mechanical Plumbing Engineering
STATE OF FLORIDA
COUNTY OF DADE
1 HEREBY CERTIFY that this is
original filed in o
A. D.
WITNESS my hand and Official Seal.
PERMIT*
State of Florida
County of Dade
Y the r
of
NMOVIpl
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TAX FOLIO NO.// -3 Al Bogld j
NOTICE OF COMMENCEMENT
THE UNDERSIGNED hereby gives notice that Improvement will be made to certa
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 If a v a i l a b l e ) 701 -? : 5----
'1G 's 41 /% k i4)
/o ,)&.felf/'
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2. General description of improvement :{ z o rl J G �
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3. Owner information:
a. Name and Address: c_1f
b. Interest in property:
i o i O
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.
Date November . 19t___ . , 19.71..
Owner's Name and Address Isadore Hankin No,54 SfieeL..�3,X'. Cq INp1,AZRe
Name and address of licensed contractotLa Roofing &Tile Co, Inc. Miami Fla. 573 N. W. 71st St.
Location and legal description of lot to be built on:
Lot 15 Block 2 Subdivision Bay Lure
Street and Number where work is to be done 12.7.3_ Na__ .E..___92f1t1__Street
State work to be done and purpose of building (by floors) Tin cap 1 -30ij felt to she thing__b4erds .g?x_il'kstell
Johns - Manville Fire King Asphalt Shingles.
and for no other purpose.
New Building Yes Remodeling Addition Repairs No. of Stories One
To be constructed of Kind of foundation Roof Covering Asphalt Shingles
Estimated Total cost of improvements $_..1995:00 Amount of Permit S 9•0Q
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, 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 e of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcorytractorrs, rk to be performed under this
permit as are licensed by Miami Shores Village.
Remarks---- -- 34SQa_ ( Sign
STATE OF FLORIDA, I
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 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. ! n
Permit No 1.22 L Date 1 f Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed) g-
Buildin_7Inspector
PLANNING BOARD
Notary Public, State of Florida
My Commission Expires
DATE
awe ,ze
to me well known,
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.