DRIVEWAYPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
D a t e 5-15-96 ` " � J o bb A d d r e s s 6 8 5 N . E . .. 93 Street Tax Folio r / 3 C b
Legal Description .. f � o` < A' h5 Historically Designated: Yes No
Owner's Address 685 N.E. 93 Street, Miami Shores
Contracting Co. Adco Patch, Inc.
' e. 5 /l/
Signature of owner and/or Condo President Date
S� y , •9.6
Notary as to Owner and/or Condo President Date
My Commission Expires:
O T1CIAL NOTARY SEAL
I VA ROMAN
NOTA,:Y PUBLIC STATE OF FLORIDA
C^ IML33 =ON NO. CC375231
MY CO H ress:o �' EXP. MAY 26,1998
l.EES: PERMIT 'Y0. 0 0 RADON
C.C.F. . S70 NOTARY
Address
Phone
Electrical
r / - a,
Owner/Lessee / Tenant Mrs. W o 0 d Master Permit # 3 �7 D�
(305) 754 -6867
3091 NW 129 St., Opa Locka
Qfif- Eddie J. Barnes SS# Phone (305) 681 -2196
State # Municipal # Competency # E - 140 Ins. Co. Travelers Ins
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Repair driveway /95p /9 —
Square Ft. 460 Estimated Cost (value) $460.00
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.
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 Contractor or Owner - Builder
57/s7 46
Date
otary as to ..actor or O / e :,4 i1 ,4.4...i.'., , " " `'
My Commission Expires: 1 ,
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ci
TOTAL DUE ' O . S6
APPROVED:
Zoning
Mechanical Plumbing Engineering
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11,*RE1,3W:i\MISSMalErice-INCISi 07-L1E1:ALLY' INDIGAIEW
KUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
HO OFING ❑
❑
owner of
kiilding Ut�v.
``.rchitect
ontractor
3r Builder
-egal
)escription
'address of
wilding
Lot
MIAMI SHORES VILLAGE. FLORIDA
DATE_._] t I • 6
Contractor's
License No.
PERMIT N° 4314
Bl
Work to be performed under this Permit
A oLt •
Subdi-
vision
Value of J O
�
Project $/ - --
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
dawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upop.,which this permit is
_ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the or• • ces d regulations
'ertaining to the work covered hereby whether shown on the pla or drawings Ain the stater nts or specifications an• tha he ass „ res ibility for work
tone by his agents, servants or employees. /�, � !✓
Signed" "! _. i v_ BY
INSPECT
In consideration of uance to me of this permit I agree to perform the wor covered hereunder in compliance with all ordinances and - • tions
, ertaining thereto and in pfrict c formity wit Ii the plans, drawings, statements or s )ifi$tions submitted to the proper authorities of Miami Shores V -•e. In ac-
_opting this permit I some res onsibility flr all! work done by either, • self, r r agent, servant or employee.
OCOALti L1-4 CONTRACTOR' OR BUILD1it 1
Amount of
Permit $
195
AUTHORITY ems.
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.
Owner's Name and Address • b
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision.
Disapproved Date
(Signed)
State work to be done and purpose of building (by floors) lf__
� ,19
o t_7 Street
7 S - 9 7 1
Street and Number where work is to be done
and for no other purpose.
New Building Remodeling. Addition V Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
/ Estimated Total cost of improvements $ 0 0 Amount of Permit $ 1 `)
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 s' •f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on • o be pe .rmed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j
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.
►e
of the above described construction, that he has carefully read fo�e going application, and that he did sign the same, and that all facts
therein by are
Permit No.__ _ = ' Date
"""� +�•� 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 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.