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1273 NE 92 St (8)Date 7 Z r Job Address /) 73 yg ?) ,57 Legal Description PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Owner / Lessee / Tenant /2/C e/ , 1' / cJ /O Owner's Address / Phone 75 7o2o Contracting Co. S�� Address 4 2 73 4 v 4- 21 sT Qualifier / phone / 5 Z 2 O7 State 1f /- Municipal # Architect /Engineer Bonding Company Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION �2 0e "t O j ) Me-n2 4./.9-01-1 o?0 giee c)&zt Square Pt. yiQ42 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 zoning. Furthermore, I authorize the above -named contractor to do the work stated. G Signature of owner and /or Condo President Date: 7/7/p Notary as to Owner an My Commission Expires ** * * FEES: PERMIT APPROVED: * Zoning Condo President . .\PAY Pe i OFFICIAL NOTARY SEAL 2 ; � - SCOTT W DAVIS * COMMISSION NUMBER p *CC255,237 * FQ. � MY COMMISSION EXP. R 26, 1997 Competency # Ins.Co. Address Address Fire Buildin Mechanical Plumbing Estimated Cost(value) 1 %CO Tax Folio Signatur or Owner- Builder Date: i/ Notary as to Co My Commission E NOTARY " f' OFFICIAL NOTARY SEAL res 6, , ":- SCOTT W DAVIS * COMMISSION NUMBER < 'Ill Q CC255237 ci• MY ICOMMISSION EXP* OF F` JAN. 26 1997 Master Permit # 3 � 4t 73 TOTAL DUE Other p -` it Electrical / Engineering 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. e ` ✓Owner's Name and Address" 12J(/ ae t A " g Registered Architect and/or Engineer me and address of licensed contractor i 14/4/ 4 Location and legal description of lot to be built on: Lot /5 STATE OF FLORIDA COUNTY OF DADE. Block } SS. APPLICATION FOR BUILDING PERMIT L....-Street and Number where work is to be done New Building Remodeling Addition MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Subdivision //�73 redi Repairs D ate /g / 199 ))�,,j v No./ � 2 .L Street 9)12 aze- '7 D2I \3 ( work to be done and purpose of building (by floors), state exterior colors (submit samples) 4420-Gi //d- /,1720 p a and for no other purpose. No. of Stories To be constructed of Kind of foundation , Roof Covering stimated Total cost of improvements S 7�f� J s�Q�� .0 ' Amount of Permit S 3 5701 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 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. /i /G /� 4 `� Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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 a .plication. and that he did sign the same, and that all facts therein by him stated are true. Permit No. ✓ Date / 14 / Read. Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Notary Public. State of Florida 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 MIAMI SHORES VILLAGE Date Job J o b Address! V./ / J L ) [ q T ' Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant X ;TI,/ in 7; n s4 jj Master Permit # Phone \/ ,US ' 't 5V ' 9 /'J Owner's Address' l a. 7 3 /J f 5 Contracting Co. j(9 f IC1 l- ET iiAt itJ1 ►V( - Qualifier 1--0a-C-: 4,i't= •7--- SQL- AviVe/ Phone State # L Municipal # a9 UL Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMB] CAL ROOFING PAVING FENCE SIGN WORK DESCRIPTIONX) f' T- iF- / 77,1,4, 7 1- G—: — 4/ 41/— W et ,oa s — Oda — it/d/f.ec. /L). d l.t1ALG,5 ofP W Square Ft. Estimated Cost (value)' ,, 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 zoning. Furthermore, I authorize the above -named contractor to do the work stated. ()2.a G7iGu n ature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date No as to My Commission Expires: y Commissio Address 10 3 ? it) (,= g ? c5T o� FEES: PERMIT (D RADON C.C.F. • g O NOTARY BOND APPROVED: Zoning Building 45 1 1 1 M Mechanical Plumbing Electrical r ei -g d' f,v7 2 Z 6 ' Ins. Co. 7'Gi . / / /Lr/ K/.svZ/t1V TOTAL DUE Engineering -uZL - 4 9. - 6 0 �� u cu 70 4O - 0 0 7S c O .rt - 574 2T; P L7 1 /�� 6 .