332 NE 92 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / Job Address ? ?c) 42_ v/ Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant /AS— / ( , /Lf Master Permit #
Owner's Address S /I/ c( Phone
Contracting Co. 0 W e
Address --?-3--7Z
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION x /_Srl c% /� 0'J °n --ten ' ✓ £'"'
Square Ft. 3 7 5- WNER ft
9 gyp ,3 S I ,(/0. t4di{ Estimated Cost (value) ��7� .
WARNING O O : ' M ST 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.)
//(- Za e-/ „
Notary as to Owner and/or Condo President Date
My Commission Expires:
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 Signature o %ontr for .r owner- Builder • ate
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My Comnn - - - - -
NOTARY PUBLIC ST -. OF FIAaIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1,2002
'lder Date
FEES: PERMIT RADON C.C.F. / 0 p
° NOTARY S BOND
TOTAL DUE 3
APPROVED:
Zoning Building i ( 1 ° Electrical
Mechanical Plumbing Engineering
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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.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location / and legal description of be built on:
Lot / N E" /3'O ip/B �l
Street and Number where work is to •e
APPLICATION FOR BUILDING PERMIT
New Building Remodeling
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
e// / 47n) No Street Al 7 c v /
Subdivision 70 !n 1% / l"I
a N� 9o g
State work to be done and pupose of building by floors), state exterior colors (submit samples)
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and for no other purpose.
")
Date
/1 Az 0‘ M 1 f64J
Addition Repairs No. of Stories
To be constructed of Kind of foggdation Roof Covering
Estimated Total cost of improvements S /� Amount of Permit S / " �J .54)
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 subcont &ctors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
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 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 foregoin application, and that he did sign the same. and that all facts therein by him stated are true.
Permit No. .2 93 7, ' Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved nate 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.
Notary Public. State of Florida
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.
Owner's Name and Address 7 ro// 0 PA rel
Registered Architect and/or Engineer
Name and address of licensed contractor 07,01(}e--r
Location and 1 d
nd leg ess'cr tgion�f lot to be built on: a �J �/
Lot / " �� 0 v aBiock f'
Subdivision 7 )S ./ / /7 / , /Q / j 1 ! i 0 J
Street and Number where work is to be done 3 3 2 Oz 92- 3t
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
VP/ k o /Li S A Pb 1( i..-) ^ i v C .�A
and for no other purpose.
New Building Remodeling Addition Repairs No of Stories
To be constructed of 3C1CA- Kind of foundation Roof Covering
Estimated Total cost of improvements S ifo Amount of Permit $ 7 `id
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)
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
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 foregojng application. and that he did sign the same. and that all facts therein by him stated are true.
Permit No. °t/('v /� Date
Disapproved Date
(Signed)
Building Inspector
ibq
Read, Sworn to and Subscribed before me.
Date / O 19 g
No. 3 3 7 Street N 9,_ S t
Notary Public, State of Florida
to me well known.
My Commission Expires
PLANNING BOARD DATE
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.
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Fortin, Leavy, Skiles, Inc.
Consulting Engineers & Land Surveyors
❑ 855 South Federal Highway / Boca Raton, Florida 33432
180 Northeast 168th Street / North Miami Beach, Florida 33162
Dade 653 -4493 / Broward 463 -7180 / Boca Raton 395 -7378
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