560 NE 93 St (4), /r 439
<% 93 57-
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PERMIT APPLIICATION FOR MIAMI SHORES VILLAGE
Date / 2 2S /Job Address (57 O /(4 9 3 s Tax Folio
Legal Description Historically Designated: Yes 1/
No
O w n e r / L e s s e e / T e n a n t J 4 4 / 7 ` G O ) / ( . / 6 7 : 2 0 / Master Permit # ei J r g 9
Owner's Address V C' 4 2 9 3 S Phone L32- 75 9 T 8 A
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUIL EHG ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
7 / ��
WORK DESCRIPTION 2C? +AO 7' /Ai - 7 C= �2 /e (2
772//17/
7a
Square Ft. Estimated Cost (value) ( 2 . 00
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.
OWNERS 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 th ork stated.
Signature of owner and/or Condo President Date Signature of Con
Notary as to Owner and/or Condo President Date Notary as o Contra
My Commission Expires:
cooreftqftvali 'UM
wry; I V111 ►.K
hei yultMCSTAIME OF Fi MDA
COOL 3;k3 CCRIVO
CC=LagtS'`n7 R1A■P N- SI 1A
My Conunission E
FEES: PERMIT <0 RADON C.C.F. ' D NOTARY BOND
/Q2 -cS,7
& b ate Z�
TOTAL DUE c- � —
Date
APPROVED:
Zoning Building ''� )1 I " I Electrical
Mechanical Plumbing Structural Engineer
/l
.9 /7E
AA f g "5
;7 ,(/ s
"
State # Municipal #
.IN FOR MIAMI SHORES VILLAGE
Address
Competency # Ins.Co.
Tax Folio /i/ 52tc /sue ,460 7
Master Permit #
F&
SS# - - Phone
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANIC
WORK DESCRIPTION
Square Ft. Estimated Cost(value)
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
FEES: PERMIT 3750 RADON C.C.F. /WV
APPROVED: Fire
Zoning Buildi
Mechanical
PAVING FENCE SIGN
•
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 s
Notary as to
My Commission
Plumbing
OF O \ ,...
Owner- Builder
COMMISSION NUMBER
s37
;n s' COMMISSION EXP.
JI�N. 26,1997
NOTARY SRO TOTAL DUE !
Other
Electrical
Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date e9/974. Job Address!) Tax Folio / /-c7 06 - e
Legal Description , ., . ,ea e '3 '71(( cx2
Owner / Lessee / Tenant �� IC� // " /Li Master Permit # 4 / 10 2 - W
Owner's AddressL , C / � 3 - � � 7 e / / Z (....3 P-?,3 Phone / . 5 3 3
Contracting Co.
Qualifier SS# - -
Address
Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECCTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ,7 <// .4 7a7dj /-z 5tc
7
f-//t
Square Ft. Estimated Cost(value)6700. cc7
APPROVED:
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 con,.t uction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated,' �■►:
Signature of owner and /or Condo President
Date: Dat
o
Signature of Co actor or Owner -Buil er
, .051
n./
Notary as to Owner and /or Condo President Notary- ;as =to- Contractor _or.Owner- Builder
My Commission Expires: My!Cbmmi "B . xpires ",L
1 , ��^ n, — 1 - 7i L
** * * * * * * * * * ik, * ��V (c *,. *� * * **
FEES: PERMIT ' ( 0. CDC) RADON C.C.F.
S NOTARY ....<00 TOTAL DUE '507-Y
Fire Other
Zoning Builcg 8//9 Electrical
Mechanical Plumbing Engineering
''"t MIAMI SH o RES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the b
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of M
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of apprc
plans and specifications must be kept at building during progress of the work.
Date , 1S-
No Street
Owner's Name and Address * °
Registered Architect and /or Engineer 1.__.___ 7_T
/ / l r
Name and address of licensed contractor t% __ v •
Location and legal description of lot to be built on:
( A Block J Subdivision_
Street and Number where work is to be done '
State work to be done and purpose of building (by floors ) __ _:.
Disapproved Date
(Signed)
•
BUILDING INSPECTION DEPARTMENT
)
ll
is
7 _ ice_
,
and for no other purpose.
New Building Remodeling ,Addition Repairs No. of Stories
To be constructed of__ —___ Kind of foundation_
_�_�______________oo hovering
Estimated Total cost of improvements $_______!_ ..... - ___ -____________________ _____Amount of Permit $ e.
Zone cubage required , __ - 4-- ' Flan Cubage n �
J l___�
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
Remarks (Signed).
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 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. -
Notary Public, State of Florida
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
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 Date Read, Sworn to and Subscribed before me.
Building Inspector 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.