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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date i a q 0 19 Job Address K 1` Q a- S I • Tax Folio Legal Description H �, l Hi ` storically Designated: Yes / No Owner/Lessee / Tenan r P Y-� 1 1 Q ' r Master Permit # l0 2 Owner's Address Phone[ 5O.S) (OEY-, Contracting CoX Address Qualifier State # Architect/Engineer Bonding Company Mortgagor FEES: PERMIT APPROVED: Zoning Mechanical Municipal # Permit Type (circle one))BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAN' WORK DESCRIPTION xte Y I O Y (Ql v‘ t `cl j tr► rn ( j.) t v1A ,)..1 Square Ft. Estimated Cost (value) 3( Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: RADON C.C.F. Building kv 41P, 1 So SS# Competency # Address Address Address ignature of NOTARY O'tract• Phone Electrical CT tW 344. Ins. Co. T (', M Tl2uE: LA) N; 7C LUij2 -1L JN 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 ir ork stated. tor Notary as t My Commission Expir r BOND TOTAL DUE /a ---?y-q D Plumbing Structural Engineer PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 6 -10 'q c Job Address a ES g r 6 12 4 5 Tax Folio -ZO - 013 — c if Legal DescriptionS.E / 9 '`f c ff /o - G Historically Designated: Yes No f Owner/Lessee / Tenant W rrt (ru, A,s4 ro V <. Master Permit # Owner's Address o2s Phone - 7S7 " 7d� 7 � Contracting Co. t /k / = R-- Address Qualifier SS# State # Municipal # Competency # Architect/Engineer Address Bonding Company Address Mortgagor Address P 70 VANILLA Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION X42 Nor yr P <U l v Oki p (e , 4 ,1, 1l-t V SL. tAit-# LA -67G6 / . `1; s4 —Vp/1 . Square Ft. Estimated Cost (value) SBC,. 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. Signature of owner and/or Condo President Date ignature of Contractor or Owner - Builder Date Notary as to Owner and/or Condo President Date My Commission Expires: APPROVED: Zoning Mechanical Building sol otary as to Contractor or Owner- Builder \Pt2Y P C/6 OFFICIAL NCTiariV S 2 < SANCIFIA 111 PIONTI L ,{; 13. N : U COMMISSION l9Y COL`�C91SFT f3 ra. n .. F .,..a: 1 ' FEES: PERMIT 1 /6 1 , RADON C.C.F. 015 NOTARY p 0 TOTAL DUE Electrical Date Plumbing Engineering Owner's Name and Address 1'0 Y i n v 5, itis-it0 ve Name and address of licensed contractor Location and legal description of lot to be built on: Lot h Color -ken STATE OF FLORIDA COUNTY OF DADE. Permit No. Disapproved (Signed) Block Subdivision Street and Number where work is to be done 2,5 NE 1 New Building 'lb be constructed of /11l /1 Estimated Total cost of improvements S (- 40 O I V V v4 1 SS. J � i Date ,,l� 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 State work to be done and purpose of building by floors). state exterior colors (submit samples) char4 1th hsede Remodeling Addition s iKind of foundation Date Date jaflUarj No Street S ree an ; 112 pressc,c rt( (111 KOO f Oho/ ex ettW' Repairs Ro ff Covering Amount of Permit 5 0 owdPr and for no other purpose. No. of Stories 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 Vlbrkmen'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 agre•. . employ pnly such `� bcontractors. on work to be performed under this permit. 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 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. Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 1 ate 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.