660 NE 95 St (8)Page 2 of 2
PROCEDURES FOR SUBMISSION OF CORRECTED PLANS
1. REPRINT PAGES WITH CORRECTIONS.
2. REMOVE OLD PAGES FROM ALL PLANS AND
SUBSTITUTE WITH CORRECTED PAGES.
A.MARK OLD PAGES "VOID" ON THE ON THE
FACE OF EACH SHEET.
B. DO NOT REMOVE BACK SHEET CONTAINING
BUILDING DEPARTMENT AND COUNTY STAMPS,
MARK THE FRONT OF THIS SHEET VOID AND
LEAVE IN SET.
C.RETURN ONE SET OF VOIDED PLANS TO
BUILDING DEPARTMENT.
3. SUPPLY AN ERRATA SHEET SHOWING LOCATION
OF CHANGES /CORRECTIONS IN PLANS.
A.HIGHLIGHT ALL CORRECTIONS ON PLANS.
CURTIS CRAIG 9/22/04
305 - 795 -2204
305 822 9987
10/27/2004 02:09 305 - 822 -9987
ONE STEP LIEN SEARCH
ONE -STEP LIEN SEARCH, INC.
13155 SW 42 ST 202, MIAMI FL 33175
Phone: (305) 822-9979 Fax: (305) 822 -9987
OPEN PERMIT REQUEST FORM
Attn: BUILDING DEPT
Miami. Shore Village
1 NE 2 AVE
Miami Shore, F133138
Please provide us with the open permit information for the following
property. Attached you will a copy of the lien letter that was faxed to us.
Please fax it to the above fax number as soon as possible, or send it by mail.
Thank, you very much.
Folio: 11-3206-013-0690
Prop: 29 NE 95 ST
Sincerely,
Morayma Diaz
Fax: 305-756-8972
Date: 10 -25 -04
PAGE 01
Signature
BUILDING AND ZONING DEPARTMENT
10050 N.E. SECOND AVENUE
MIAMI SHORES, FLOR)DA 33)36 -2302
TELEPHONE (305) 795-2204
FAX (305) 756-5972
RECEIPT
O ct L l tL444 kdt.. I 1 , picked up 2 sets of plans for
(address) C2(u Q S S 4- from the Building and Zoning Department on (date)
t 0 / g /6 Y to have corrections done to plans and/or get County stamps. I
understand that the plans need to be brought back to Miami Shores Building and Zoning to
continue the permitting paucess.
;;■;y CHARLES D. MEDEIROS, A r c h i t e c t
N E ▪ • 827 SANTIAGO STREET CORAL GABLES, FLORIDA 33134
• LIC. NO. AR 0012990, ID 0003837 TEL. (305) 443 -7569
November 1, 2004
Building Department
Miami Shores Village
10050 NE 2 Avenue
Miami Shores, Florida 33138
Re: Office Building Remodeling
660 NE 95 Street
Miami Shores, Florida 33138
Project No. 0307
RESPONSE TO BUILDING DEPARTMENT COMMENTS (Permit No. BP 04- 1246):
Building:
1. Electrical, mechanical and plumbing permit applications will be submitted as soon as a
contractor has been selected for the project and has signed a contract with the Owner.
2. There are no new or modified windows in this project. All windows are existing to remain.
3. See Drawing A -8, Detail 2 for new wall section (UL 419 1 hour fire -rated tenant
separation partition) and Drawing A -2, revised Legend.
4. Miami -Dade County Fire Department has reviewed the plans (see stamps on the
drawings).
5. See clarification notes on Drawing A -2, Floor Plan.
Sincerely,
Charles D. edeiros, Arch ect
cc (transmittal only): Mr. ach
MIAMI -DADE COUNTY FIRE RESCUE
REQUEST FOR MUNICIPALITY PLANS REVIE
Fire Dept. Plan Tracking # (FOR OFFICE USE.)
Previous Track # (FOR REWORK OR REVISION.)
Fire Dept. Application #
Permit Type (CHECK ONE.)
uilding Permit
0 Fire Alarm Permit
❑ Sprinkler System Permit
❑ Fire Suppression /System. Type:
❑ Water Main Ext./Fire Hydrant Permit
0 Other Permit
Pe it Information (CHECK ONE.)
Stand -alone Permit
0 Subsidiary Permit
❑ Master Permit
SCOPE OF WORK: tj2 c6) QR cm . j , ldv t �'e, rtli ADA- C'o4D I r �'
V P t�S tinter 1 / p e_e.a) .0-1 .(64
PLEASE PRINT ALL INFORMATION CLEARLY.
Project Name: o(.P 0 CpAci � "At ni il i (iLctq - is AC
Job Address: Wen j - 4'..44,,, . ' g I. J M Vii.'A,4 i skt „ PS o
Municipality of: ,1. i aim- t S S te: 0 Zip: - q . / 3D
Contact Person: CA) i t l 9. ow, 6 Q..
Phones: #1 006j_ _ ' C( - / :S:7
Q L?o S
__many Name:
#2
c� 4 �,oS
/ -� ,� q 8& S 7&/ Permit Relationship: (i.e. Owner, Arch., Eng., Expeditor, Contractor, etc.) rc.lt ' k
Cost of Contract: $ t2-01 PD 0 Square Footage: GCCSIZ3 Number of Stories:
Number of Heads/Devices:, Number of Units:
sip
NOTE: Our department will make every effort to have Fast Track review within 3-5 business days and Drop Off review within 9 business days.
0 1 have read the above NOTE and I am requesting a Special Request Plans Review to be scheduled as soon as possible
at the rate of $190 for the first hour and $65 per each additional hour in addition to the review fees. Minimum charge
one -hour.
Signature: Print Name:
For Office Use Only
Registered by: 14.1-4-4V, Date:
Drop OffiRevi
11 GO
Fastrack Review: N /A:
For plan review information call: Miami -Dade County Fire Engineering (786) 315 -2771
OD 7q5
R � ev Status (CHECK ALL THAT APPLY.)
1M ew Permit Application
0 Rework of a plan still in process
0 Revision to an existing permit
0 Expired Permit or Renewal
0 Restamp
0 Not Applicable for Fire Review
0 Other
Approved ( Disapproved N/A Fee $ ',Z 0
achanocal Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2005 -11
Printed: 2/3/2005
Applicant: WILLIAM BACH
Owner: BACH WILLIAM
JOB ADDRESS: 660 NE 95 ST
Contractor SANSONE CORPORATION
Local Phone: 954 - 428 -8919
Parcel # 1132060500010
Signed: (INSPECTOR)
Contractor's Address: 590 GOOLSBY BLVD.
Permit Status: APPROVED Permit Expiration: 7/18/2005 Construction Value: $38,685.00
Work: HVAC AS PER PLANS
Nk,
Page 1 of 1
Legal Description: 660 CONDO UNIT A UNDIV 38.91% INT IN COMMON ELEMENTS OFF REC
Fees: Description Amount
FEE2005 -1454 Building Fee $1,353.97
FEE2005 -1455 CCF $23.40
FEE2005 -1456 Training and Education Fee $7.80
FEE2005 -1457 Technology Fee $33.85
Total Fees: $1,419.02
Total Fee41,419.02
Total Receipts: $0.00
909 PAD
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
•
j rP
1Anfl
Bi Cditi
PI
FB
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
795.2204 Fax: (305) 756.8972
Permit No.
co - /1
Master Permit No. ,e4/p- OV Jay6
Permit Type (circle: ical Plumbing
Owner's Name (Fee Simple Titleholder) � (� ('t e(0 ,4S' Phone #
Owner's Address i 6 / % 9s-s=
Roofing
City t ( ,(,(.(t State Zip
Tenant/Lessee Name
Job Address (where the work is being done) to 60 AJ E 9 6 nT
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name 54115014e. CO Qpd IZATI 014 Phone #
Contractor's Address 59 G,DO Bhp - "aL.V1")
City �iEL�j State rt...
Qualifier S co`r - r SAN St) ILL C
State Certificate or Registration No. CSC. ) 9 . 1 - 1 1 1 e[ ID D Certificate of Competency No.
Architect/Engineer's Name (if applicable)
36 6e
$ Value of Work For this Permit
Type of Work: ❑Addition ❑Alteration ENew
Describe Work: OVA C As T E e. LA IQ
Total Fee Now Due $
(Continued on opposite side)
Phone #
Zip 3 7W ( 42
Pho
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ � L� CCF $ a3. V CO /CC
Notary $ —°- Training/Education Fee $ y b Technology Fee $ 3,- g' �
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
L/ . Oa
Zip
96 ya 8 - 89 l 9
❑ Repair/Replace ❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage - Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
r = ot Y;'Pr' LENE'E M. BARSTROM
.. ri+ ;A : MY COMMISSION # DD 089455
Signature Signature ; ; .. _
it f. 7 '` Bonded TVs' Wan/ Public Underwriters
Owner or Agent L, 1 is si *
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Jq2
day of , 20 _ , by , day of J iq.v A Q Ai, 20 Qom, by SCAT'i SA M:Sp &L C,
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBL
Print: Print: it/>E6 /Y `r AiQ.,SY"IQpwJ
My Commission Expires: My Commission Expires: 6/06,
************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: Ir/ Plans Examiner
Engineer
Zoning
Chc 05/13/03
BUILDING
PERMIT APPLICATION
FBC 2001
Submittal Fee $ Permit Fee $
Notary $ Training /Education Fee $
Scanning $ Radon $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2q51 Miami Shores Florida 33138
Tel: (3 5i, 1 f p 175,.8972
VilkY 9 2!3 I
fl Permit No.
Permit Type (circle): Building Electrical Plumbing
Owner's Name (Fee Simple Titleholder)
Owner's Address
City State Zip
Tenant/Lessee Name
Job Address (where the work is being done)
o tic: ‘• r
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Namec-54/ c E ` O ie a e4-71 # 9C / - / r ^ 91 9
Contractor's Address (-5-9D / Goo Sal 6 L) sIO e_-3,__ „deh
Cit y rc�iV /E 7 v
C4 A n State FL Zip 33 ( AV "
Qualifier �5 7Y �4A/SO/1/L
State Certificate or Registration No. Certificate of Competency No.
Architect /Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Square Footage Of Work:
Type of Work: ['Addition ['Alteration ['New ❑ Repair /Replace ❑ Demolition
Describe Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * **
t S * * *sF• *** * ** ** * * * * * * * ** * * ** * **
\ b
Structural Plan Review. $
Zoning Bond $
aster Permit No.e#ee-1 21 40
Phone #
Phone #
Zip
CCF $ CO /CC
Technology Fee $
Roofing
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20,by , day of ,20,by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath:
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires:
********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05/13/03
My Commission Expires:
* * * * * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
4
Plans Examiner
Engineer
Zoning
Contractor SANSONE CORPORATION
Local Phone: 954 -428 -8919
Parcel # 1132060500010
Signed:
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2005 -11
Printed: 6/2/2005
Applicant: WILLIAM BACH
Owner: BACH WILLIAM
JOB ADDRESS: 660 NE 95 ST
Contractor's Address: 590 GOOLSBY BLVD.
Page 1 of 1
Legal Description: 660 CONDO UNIT A UNDIV 38.91% INT IN COMMON ELEMENTS OFF REC
Fees: Description Amount
FEE2005 -1454 Building Fee $1,353.97
FEE2005 -1455 CCF $23.40
FEE2005 -1456 Training and Education Fee $7.80
FEE2005 -1457 Technology Fee $33.85
FEE2005 -7140 Building Fee $100.00
Total Fees: $1,519.02
Total Feesik1,519.02
Total Receiptsk1,519.02
Permit Status: APPROVED Permit Expiration: 10/9/2005 Construction Value: $38,685.00
Work: HVAC AS PER PLANS
(INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
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 ;hall 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.
1 Date / ° 1 19 C
'
Owner's Name and Address i 'l i� ��
No Street
Registered Architect and /or Engineer
Name and address of licensed contractor '' , -!`- A = s, y { � "v �; e -?
<j
Location and legal description of lot to be built on:
Lot Block SubdiCiia C)
Street and Number where work is to be done
STATE OF FLORIDA,
COUNTY OF DADE. ss
Permit No
Disapproved
(Signed)
Building Ins.ector
Date
Date 1
State work to be done and purpose of building (by floors)
- and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation / Roof Covering
Estimated Total cost of improvements $ 6 , er Amount of Permit $ _1 '
Zone cubage required _Plan Cubage I
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 pennit 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. ,� ?!l- -
Remarks (Signed) U4 Id :2-'4'Z /,-; i ' '; 2
f o
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 fc}regoing application, and that he did sign the same, and that all facts
therein by him stated are true. ,f
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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.
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 ...._- •......
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done..fG?
144
St a w.rk to be done and urpose of building (by floor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Sub ision
Date 6 —' 1 ,
No Street
Z s' to, 8
l/ and for no other purpose.
New Building Remodeling. Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $.. 0/.0 -0
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 wor ch public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, n work to be pe fo med under this
permit, as are licensed by Miami Shores Village. l
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
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.
((// � / If ) c-�
_. Read, Sworn to and Subscribed before me.
Disapproved Date f )
Notary Public, State of Florida
(Signed) c�.. -� �= ............
Building Inspecto My Commission Expires
NNING BOARD DATE
Chairman r 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
-4
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MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buil ing Inspection Request
Date (D
Type Insp'n - F - t 1na I
Permit No. C.,05 1
Uies1Qr
Address & C,'c IV? a q3 s-J--
Company
Phone #
Name
1
H 4Pi06 -Pt -0 5
Inspection Date GI �`-
Approved ❑
Correction
41 (
Re- Insp'n Fee ❑
i0J S 1...„ c Acc
44,x.67.4 s fa/L
Ad w of C 0-
Tam -
Address
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
30S- 795 -2204 m
Building inspection Request J
Date„ 6
Correction
,Re- Insp'n Fee l�
\ V \J
C AIQ'F J 0 •-J ,'1a
"Sype?nspn • •� �7t `�
, Fernnit too. _frtC. O a " ! i - --
Compary
Phone S � S C 7
Itiapection Date 4_ _
Apprnve 811-'t
Address
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date doin(05
Type Insp' n NC- flYtUA
Permit No. 1 �e.�5 -
Y��l, \l fl
Name . .
(hh( kit c.5
Company L C
Phone # % -Sqj
Inspection Date
Approved
Correction
Re- Insp'n Fee
A GG SS' ./
/fi's
h�5 5
00' 0
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Date 1145
lyrpe 'm0n t w ,,_
Permit No. W ?1 5 `l
Nine V14%04, O\
Address LLD IJt ct.5 w
Company %VA- altt 1!�
Phoned C let - 475g 184'
Inspection Date 1 Q
Approved
Correction
Re•Insp'n Pee
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
PERMIT
Address of
Building .�
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
N9 4214
Work to be performed under this Permi
B1
BY
DATE 19
Contractor's
License No.
Subdi-
vision
Value of Amount of
Project $ f II Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in complicancb with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY ..BOT •^d+