Loading...
PAINTRemarks mil0AM0 SHORES \/0 ,LACE BUILDING INSPECTION DEPARTMENT APPLDCATOON FOR =- LIOLDO !G r•ERMOT (Signed) Application is hereby mode for the approval of the detailed statement 01 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 iuilding 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. 8 Ow-ner's Name and Address 012 _ No./2.7 ..._.._. Seree¢2 , Registered Architect and /or Engineer .• Tf.t t•• •,:,•••t „•,.t,nne,w.•,•ITS tttt, e•- It Fame and address of licensed contractor QS n Location and legal description of lot to be built on: Lot /1 Block ,t Subdivision.... Street and Number where work is to be done 1 ;76 (ve t 1. AAN`'l In.oi�S State work to be done an purpose of bpilding (by floors) Plk.T I NiTEgicw. - TE121i).P..., 'AIr uT rRp E _.111 KlTC, 11.) CE ( xn l Oa* F C. \eZ 7. 7 ICE v L) . T Gl1Qr. 12 \ r W BALL and for no otherzurpoa . New Building Remodeling h Addition Repairs x No. of Stories _ To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 2,0o 0 Amount of Permit $,. Zone cubage required .Plan Cubage Distance • to next nearest building. Size of Building Lot _ .................. _........- Maxiunum 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 \Vorkmen 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 , • work such public notice or noticcs as arc required by the Act. The undersigned agrees to employ only such subcontractor rmed under this pcnnit, as are licensed by Miami Shores Village. 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 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 eettrue. Permit No. s!. Date .:.Y. --I... t".)--- ......._._ Read, Sworn to and Subscribed before me. Disapproved ._ t� .. -_. Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires to me well known, PLANNING BOARD DATE Chairman Member Member Member Member .. .. _- ...._....- •- • - - -._ ...._....... Member Council Approved Date Disappruv .. Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application niter approval has been obtained from the Plannir.g Board. A rc inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection as faulty materials and /or workmanship. Owner's Name and Address 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 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. Registered Architect and/or Engineer ' �j / 7( and address of licensed contractor L/ 41 /1/k /2 i l ( 1 C /] 7 r L-State work to be done and purpose of building (by floors). state D ' exterior colors (submit samples) Date .57/// 19 No. /--g7 Street Xi— 1, Location and legal description of lot to be built on: r� Lot /! Block (7 Subdivision / r // ,J ,2 A, r / 0 g® r reet and Number where work is to be done / / f J 7�Y ` 2 ✓ St and for no other purpose. New Building Remodeling Addition Repairs (-------- No of Stories To be constructed of 1 Kind of foundation °� Roof Covering stimated Total cost of improvements $ G 100 Amount of Permit 5 </ 25 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 t 's 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 • employ o h ubcont actorrs work to be performed under this permit. as are licensed by Miami Shores Village. �i Remarks ISigned'� / • 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 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 application. and that he did sign the same. and that all facts therein by him stated are true L Permit No. oC Date) / /f / ,?7' Read. Sworn to and Subscribed before me. Disapproved Date 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 525.00 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. Date ri Legal Description Owner/Lessee / Tenant PERMIT APPLT[CATIION 1Vll�L"111Vll�� F° Job Address 121 `� '(\e_ q � Tax Folio Owner's Address %1 LO 0e_ 9 3 5 1 Contracting Co. Qualifier State # Architect/Engineer Bonding Company WORK DESCRIPTION licli`tr(Q FEES: PERMIT 1(Or RADON APPROVED: Zoning Mechanical Municipal # Mortgagor Address Permit Type (clink one): DUILDING ELECTRICAL PLUM C.ING MECHANIC L ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) $ WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURIE TO DO SO MAY RESULT IN Y e °UR PAYING TWICE FOR IMPROVEMENTS TO YOU E' PROPERTY (IF YOU INTEND TO 0 : TAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY I ®RE RECORDING YOU 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 ' compli• a ith all applicable 1awsi gulatin ns truction and zoning. Furthermore, I authorize the above -n • - contractor to do the work s d. ‚ c7 gnature of owner and/or Condo President te Building Notary as to Owner and/or Condo President Date My Commission Expires: Historically Designated: y� (� Maste I Jt� T L j Phone Address Address 71(617iel SS# Phone Competency # Ins. Co. Address Notary as to Contractor or Owner- Builder My Commission Expires: e nv Po C.C.F. C) NOTARY TOTAL DUE Plumbing Engineering 0 Electrical DESIGN STUDIO WI JTE • WHO1A to TERRACE • WHO2B Date Date J )