MECHANICALDate
Legal Description d 4 E.45/ 7 3 MS SE c/
Owner / Lessee / Tenant L at�il/ ��JF Master Permi t E)(I S /Add
Owner's Address /// G /U er 9 3 SP
Contracting Co. LOC4L #/4 a OND /n0/t) /.j Address AL__,. / S7
Qualifier q i'/ /N• 24E SS# / Phone / «&P20
State #69 0 Competency 0 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING ROOFING PAV G FENCE SIGN
.3 A/
WORK DESCRIPTION
EP cENe Jr ,e 4rvAz•1J ,A4! / Aia
Square Ft. Estimated Cost(value)2_1!2i720.
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
be done in compliance
authorize the above -n
Signa re of owner and /or Condo President
Date:
Notary a
My Comm
** *
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address46 ,06 93 Sr Tax Folio // 320( /3 369 8
certify that all the foregoing information is accurate and that all work will
with all applicable laws regulating construction and zoning. Furthermore, I
ed contractor to do the work stated.
Owne G mSS
f�
um A�oo d r President
Expi om
September 25, 1994
vu NZ' BONDED TIM NOTARY PUBLIC UNDERWRITERS
FEES: PERMIT 1 P1‘ 4 7 RADON
Zoning
Mechanical.
*
Notary a to Contractor or Ownr- Builder
My Co -'�' "�, Ex HY COMI�KTSION &XPIRES
��QN IV N
a; . •, � •
$1100171WW25, 1994
,„ia BONDED TN MUG NOTARY UC UNDERWRITERS
* * * * * * * *
C.C.F.
Fire Other
Phone 7s fe/y/
s v .o,t y / 52r-t° Jv is.
6
Si�iature of Contractor or Owner - Builder
Date:
NOTARY TOTAL DUE ',
Building Electrical
Plumbing_ Engineering
**
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...14' .2–.1''---- . _._! ...._ ,18/
Owner's Name and Address ...... . .� -' °....l.Y ..._ — No... 5� _ . Street . ..�,t` !? s
Registered Architect and /or Engineer
Name and address of licensed contractor .6 G v n
Location and legal description of lot to be built on:
Lot Block Subdivision
Street
/
Street and Number where work is to be done . D _ it / �L _ . '2 i /e`rf
St -- ate work to be done and purpose of building (by floors) 1/ 5..1 f.'... ...– y /° /' 41 � �ii,� - s U / / ! ✓..I?..G.
.and for no other purpose.
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Disapproved .,1� Date
(Signed) l
/
ITt ••! .. T.! !ft t. W I .
4 _..
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 6 Amount of Permit $.
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, 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pennit, as are licensed by Miami Shores Village. �
Remarks (Signed
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 ss ed e true.
Permit No..__`: . ! Date C'� / ° 7 _ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Expires
to me well known,
PLA INC BOARD _._... ...DATE
Chairman Membcr
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 oe faulty
materials and/or workmanship.
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.
Owner's Name and Address t k N ( 7 t g n1
Registered Architect and /or Engineer
Name and address of licensed contractor em
Location and legal description of lot to be built on:
Lot__ Block Subdivision
Street and Number where work is to be done_ / h S 7 �G L ®� re ° ' 4
State work to be done and purpose of building (by floors) —.-------- __._._------------- _____._..__...........
__
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
ate_
Tc -a e v
Date
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Cnvejng
Estimated Total cost of improvements $ ? c3 — Amount of Permit $
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 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. A l
Remarks - (Signed) / ` «!t. ea, a c _ t. 7 z. iZ _
/ Q
,19
No /& Street
g ao 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
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 / ( - 2
Disapproved
(Signed)
Read, Sworn to and Subscribed before me.
Date Disapproved
Notary Public, State of Florida
B uilding Inspector My Commission Expires
PLANN BOARD._ ___ .. DATE
Chairman .._ Member
Member Member --
Member ... _ Member
to me well known,
Date
NO : charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Plann g Board.
A re- spection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials a d /or workmanship.