ROOFINGMIAMI SHORES VILLAGE
BUILDING INSPECT[ON DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed state:.:enr or tare 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 nsust be kept at building during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor fru% A1.1-5 .._2 � C ' S d '5111 rde /J /-CT
Location and lfgal J descriptio of lot to be built on: �-p�
Loth il °,
6 7 ''as Block a 49 Subdivision.... .A / h .. -W. .1 S 3 /ea i __
Street and Number where work is to be done / 1.-. ka..:.y 3 , .. -.1 i! .:;...sid e es-
si.ate work to be do a and urposc of building (by floors ). 0 Or . 5 1 ..4'a 6 a'.z _5
.6. Al, A,e6-t....(<C).4lL .: _. 6,J to Clerrf� i+�. ..S.et. . SFo .,t7C!th(LZ. for no other purpose.
sa _ •
New Building Remodeling Addition.. Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering . ........... ..._..__
Estimated Total cost of improvements $.• 4 • ,4!ioa' °6 Amount of Permit $. e
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 buildinn and its construction may
be sent to.. S:,.1']ii'I.eA rr1 SLI . /9.5 5-Q... La-...f . '(..i` /fit s'A Pt- . F /.. .... 3v_s-Sf
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 \\'orkiuen's Compensation Act, being Section 5066, Compiled General Laws of Florida, Permanent Sap element,
anti has complied ssnth 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 pulelic notice
or notices as arc required by the Act. The undersigned agrees to employ/ only such su ntractors, on woe to be performed under this
pcnnit, as are licensed by Miami Shores Village. t
Remarks..._ (Signed
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 twat 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
{ ree t ue..
Perm No.._..__ ..� _ t Date 1 J..)
..... '- .._.....- -- -._ Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Building Inspector My Commission Expires
— No./Srtl'..4 Street._. -.. 3 ._
Notary Public, State of Florida
to me well kaown,
PLANNING BOARD DATE
Chairman Member
\fcrnber Member
Member Member ...._
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Date ( "////93 Job Address /5 AJ £ 93 Ai Sr Tax Folio //- 3 - /✓ 3 C
Legal Description
Own / Lessee / Tenant �jv2AY1 /et'? fr
/ .sZ 93 SI
Owner's Address
Contracting Co. 1A)/ 7
Qualifier
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
774 co) £D
State # Municipal # Competency # o 3(<t Ins .Co ✓ '4(' -IC 0 A
Architect /Engineer N/L Address
Bonding Company i44 Address
Mortgagor f"4-1
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 7A'-0A f bets. rJ su C / /A T /f 4) )/zor.) i cy 0 vs I.
�f��RGei l u/ 3 04- `E 7i P/Y I S' f18 A c$ /.9Sl
Square Ft. 2-
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 fo -:•ing information is accurate and that all work will
be done in ompliance with all applic - aws regulating construction and zoning. Furthermore, I
authorize /he above -named or to do the work stated.
Si: =, e o o
Date:
J( ` � nr al�t t�lG::rki �r
APPROVED:
r Condo Presidsat�.
OFFICIAL NOTARY SEAL
PLICI GIORDANO
Y PUBLIC STATE OF FLORIDA
7 P133
No ary as to Owner;0410 r• Qdhdb reaide 7
My Commission Expires:
* * *
FEES: PERMIT RADON C.C.F.
Mechanical
£ e
Master Permit # 3%`
Phone 7570
Address O8/ W 2-1 C:7 IA1(-414
Phone (Pa/ - 7 4
Fire
Plumbing
Address
/ fill Rt1111dirt - oi4 Mnp bow l
Estimated Cost(value) 7 d a
Zoning Building
Si natur f of na4'i iiiii E ner ;Builder
Date: F ICI GIORDANO
1 NOTARY LIC ST TE OF FLORIDA
.._ ISS'_CN $O CC272133
Notary as to Contractor d Tv/her-Builder
My Commission Expires:
* * * * * * **
NOTARY TOTAL DUE '3
Other
Electrical
Engineering
COV ITAC:ES
CATE ►I0LtMF1
AMA)
CERTIFICATE 0
T
U'AN
CANCELLATION
1
SHOULD ANY OP THE *EMI DESCRIBED ►OUDIU B1 CANCELLED SWORE THE II.
PIRATION DATE THEREOF, THE HI COMPANY WILL INDIAve11 TO
LEFT, BUT aAILLURS O ( MAIL SUCH NO ICS SHALL IMPOSE NO OBLIOATION 011 LIABILITY
OF ANY KIND . THE .. ANY ITS AOINTE PRESSNTAT
•
IIr1 /Al'1)ht) 1 0 111' ,Ttn I IUN I '111
CO
LtR
INSURED
Of
PRODUCER
► I
JLIN
JACKSON AGENCY
P.O. BOX 110310
HIALEAH, Fl. 3301 1 -r '
?c2-$/— 3 7(41/
W,A.T.S. INC
8081 WEST 21ST CT
HIALEAH,FL 33016
NQTWITHITANDINO ANY R10 jIf NTT INSURANCE R R LISTED ON OP ANY CONTRACT OR OTH D OCUMENT WITH RESPE T WM CI4 TH I1 CEq� CERTIFICATE MAY
BE ISSU10 OR MAY PERTAIN, THE IN$LIRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I1 SUBJECT TO ALL THE TERMS, ExOLUSIONS, AND COND$.
TIONS OF SUCH POLICIES,
TYPE OF INSURANCE
OINEMAL LIABILITY
COMPREHENSIVE CORM
PRE
D(PC & WIIAPSE HAZARD
PRODUCTS /COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJI)RY
1=1•1r.1m...M1•wi r•eue
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PASS.)
ALL OWNED AUTOS ( PAN.RPA98N)
HIRED AUTOS
NON•OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA REIM
OTHER THAN UMBRELLA FORM
OTHER
WORKERS' COMPENSATION
AND
EMPLOYER.' LIABILITY
CITY OF MIAMI BEACH
55 HANK MEYER BLVD
MIAMI BEACH FL 33139
T.B.A.
APPLIED FOR
POLICY NUMBER
DESCRIPTION or OPERATI /LOCATIONBNE:HICLES/SPECIAL ITEMR
6 -03.93
11 E 0 0 R I ISSUED
AFFORD, Y � O, coNPIES
N RIGHTS UP E $$% AT
NOT AMEND,
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER ASSOCIATED EMPLOYERS INS COMPANY
COMPANY
LETTER BP
COMPANY
LETTER
COMPANY D
LETTER
COM NI
DAIS IMAV 1
4 -28 -93
POLICY ExPRAIION
0411 IMAVOCAY)
4 -28 -94
INJURY
• O E
111 • PO
COMM
l►DI i
PERSONAL INJURY
Y
PIA WORM
PROPERTY
DAMAGE
EI 1 PO
COAMINEO
LIABILTY LIMITS IN THOUSANDS
CCOM11NED I $
STATUTORY
$
$
$ 500
AOOREGATE
$
$
$1000
$
(EACH ACCIDE •
� ,C'SCASE•POLICY LIMIT)
(DISP? 3E•EACN EMPLOYEE)
;VALIDATING No921'f 1 70305 OXMAN, UPTOWNS #0 ice.;
♦i I I r► I I I I I I I 40 i I II - I I I I/ I' I
i gIdOw I/ I I I I I I I I I I I I I
OCCUPATIONAL LICENSE.
CITY OF HIALEAH, FLORIDA
`NAYOR41ULIOIRARTIINE
•
The person, firm or co
spectftec� subject to th
if Nf:RAt.4.CONTR
INC
-mutt 12T• CT
:,MIALEAH4
33016
>
•
;, Via•.
• i Amoun $ $V.8 1 e
engage In the business
I y of Hialeah, Florida •'_ •
NOTICE:, ill it
All businesses are required
td obtain a Dade County ; :
Occupational License. "
ors
SOS
00\
-300
m
m
•
N-(
m fr
nArnIt72
11C ►N^. ►'sr+
tC [!1401411
.... ._... • ••• ••••••••• w►+waw...... •w iv •
AIIMT CONTflO1 ,.o. 1907 7 21
MTC11 NQ AMMO? MT
00206 1240.00
PO OFFICE C INDUSTRY litENStNA
At
J ACKSVIVILLE• f 12291
1 M 1 PrIf r ^ .NigAIIIT it
1 w• rAPn --. r0111 WIT
S tME OF FLORIDA
DEPARiMENt OF PROFESSIONAL REGULATION
CO Nl 1 l E N 1 I N :431VIT"
CERTirtE0 POOPING tehUUUA(TO11
WIEsEM. TEO UAW �
W A T S 1NC•
11A3 PAID THE EEE fEQUIREU I)Y CIIMtER
ron 111E YEAfl EXPIWUINU AUG 1+ • 10
I A t„ 7 ' (_
LAIN IUN CI 1111 ^.
OOVInHnn
i
y ■•
5f4
Ocv pik7'7o -... 44,
1
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n ,
I tW PN,f! Np. AUDI? c iNk 1 X7
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PA
P o NN S To C y t ON e I N,VI :t
( tttllitMS' •
I ACKS ONIIIIIE♦ • FL'lint(
0EOAMagi STAT
1
f :cENtt fi$ jugtiii«e
•Mto ' I I
i :,Th i I
' 1-1A8 pA1b PEE RR
ron n" . YEAR EXPE11NO
umf 1 o CHILES
QONRRN
t rE1f9F,E AM1 /1A7ljl
r %Nur QAHH me wit
Date �► �ob Address407.2-- 2 - i' idly Tax Folio
Legal Description
Owner / Lessee / Tenant
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
,c7
Owner's Address 1472- ,
Contracting Co.
Qualifier _ •.. . „ Lea • . - Phone 6196 — g5gg
State # Q 7 7 , ` 5$ Municipal # Competency # (O7gr? Ins.Co. Qrk4 Q " Star--€L_.'
Architect /Engineer c Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ZArao'F 6?r y Q ;- treat/` L a\-, F,110.0-204C 4o,,,,�) 1
t&Jat i _ to-- T® y V\Itst" Q96 \C"
Square Ft. 2: 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 c.o 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 _ ,- -n -d contractor to do the work - tated.
Notary
My Commis
** *
APPROVED:
* * *
nd/or Como resident
ST .. OF FLORIDA
My Comm P8/29/95
BONDED
* * * * *
FEES: PERMIT VIOD RADON C.C.F.
Fire
Master Permit # Z -'
Phone
Address /9 A y J ?S �-
'r ,y %; `
ur e of
Jr Notary as to Contractor or Owner- Builder
My Commission Expir T ARY PUBLIC STATE OF FLORIDA
MY COFri IiSSION EXPIRES 5/09/94.
* * * B ridt#1 ihru Sttnbler.Ade►ts & SwIfIft
NOTARY 5" TOTAL DUE b e d
Other
Zoning Building 1. 7)"■ 4/ Electrical
Mechanical Plumbing Engineering
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FIJR 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 February 2 7_,, ,1969
Owner's Name and Address____Mra.___Minn; a__F.o1 No.152__M_ o __ Street 93 .h
Registered Architect and /or Engineer
Name and address of licensed contractor W.R.R bins__.4 __Son-Roofing C -Q-. 121 1 -- •1�j +- -'20 -- Street. - - -Miami
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 152 —N. ,93_tih_ reej.__I�� a2t1�
State work to be done and purpose of building (by floors )______RIInlove__IIld___r_o_nf apply 1/3.0 #1___2/15#
asphalt and gravely
and for no other purpose.
New Building Remodeling Addition _ Repairs X. No. of Stories 1
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $____ 198500 Amount of Permit $ 7.4:44
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 _and--Son--Roofing
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 subcontractor ,, ,pn wo,;k 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.
Permit No 1 a Date C7 Read, Sworn to and Subscribed before me.
Disapproved D
Notary Public, State of Florida
(Signed)
Building Ins• ctor 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.