ROOFINGMIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ DA" ` i.;.._._
ELEC, ❑ PERMIT I 12253 Contractor's
Pl 1:: �.icense No.
RO Work to be performed under thus Permit
Owner of
Building ' O ‘...3 - % iJ"
Architect
Contractor
or Builder a ""'� " ��r
Legal Lot
Description
Bf.
Address of r � � �.
Building `1
Subdi-
vision
Value of
Project
The permit is ranted to the contractor or builder named above to construct the building or to instaflthe equipment or device described in the application
herefor in redo compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawingsi eealenente 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 wait 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 11 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 tig he assumes responsibility for work
done by his agents, servants or employees.
CONTRACTOR OR BUILDiR!
Signed:
$
11
BY
Amt. of
Permit
In consideration of the issuance to me of this permit I agree to perfo work covered hereunder in compliance with all ordinances and regulations
mining thereto and in strict conformity with the plans, drawings, statements or specific • ons ubmitted the oper authorities of Miami Shores Village.
n aomptang *Is permit I assume responsibility for all work des er, myself, my <gnt, e ,ant o . to
AUTHORITY
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 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. (,[
- l
• �'
s
Owner's Name and Address L. Date
No
/ Street � �' ,--0" 19� 1
Registered Architect and /or Engineer - °
Name and address of licensed contractor_________' 11:_�.�, �- " � _is ' w- LL.L 2
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)_ _ r_
ll
0
and for no other purpose.
New Buildin_____ Remodeling____ Addition Repairs No. Stories
To be constructed of Kind of foun ation Roof Covering___ S D -- / ` f -D _ tr
Estimated Total cost of improvements $ 7_ Amount of Permit $
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
STATE OF FLORIDA,
COUNTY OF DADE. Ss.
Disapproved Date
(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 suh- contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for ' nspection on the site o e work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s c tractor , on wore pforzned pride this
permit, as are licensed by Miami Shores Village. j 1 r � _
Remarks ( Signed ` � 1 1 t d. l !l r' -/ i
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 _a ____ 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
m rials and /or workmanship.
Date /1 /4 0' Job Address 77 1V 93 fZ v 3riq;67, Folio ll 1.�' 3 P
Legal Description Lit 67-1;,?' 4AlFlJ
/ Lessee / Tenant 0 7 / U1 S • ()CH e �l [ ° J Al Master Permit kf'
1 FT 33/3r
S V u . , . Phone
Owner's Address
&.'3M Yuji c.) c
Contracting Co. f ) n 4)1.r , 2 ( e 2 nP. r y ' S 1 S7 ni Address
Qualifier SS# - -
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICALC6TFING PAVING FENCE SIGN
WORK DESCRIPTION
3 F. �s .s- .
Square Ft. /9 -
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.
Silrature o er and /or Condo President
Date:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1:
No»'arVas to Owner< and /or Condo President
My Commission Expires:
*
FEES: PERMIT ,0 et) RADON C.C.F. 14 NOTARY TOTAL DUE 04 ; 4 !&O
APPROVED: Fire
Estimated Cost(value) ( 9.c,/ / 00 0
Notary as to Contractor or Owner -Buil
My Commission Expires:
n„ A
* * * * * * * . L: i t= **
Phone 9 V77
Sig ture of Contractor •r )'
r
Data:
Other
6�I
Zoning Buildin: Electrical
Mechanical Plumbing Engineering
STATE OF FLORIDA
COUNTY OF DADE
1 HERE3Y CERTIFY that this is a
original fiiad Jg js, grfica o
� / � / , A.D. 1
WITNESS my hand and Official Seal.
2. Description of improvement:
NOTICE OF COMMENCEMENT
928407851 1992 NOV 02 12 :00
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. .J
1. Legal description of property and street address: 777 { .7 J 44— c )V,/ - � gz / _ "`-.
3. Owner(s) name and address: /MRS . t.wr�%'� t t (6L'E--i ►J
9 7 7 N4 E q.3 KZ. s; fta r ��„ t 5 Q I N (3 53
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: �d►�tiSP��i.� gG'gs��� ,� 4 A -PowL
•
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
Fteo
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signa ure of Owner
Print Owners Name
My Commission Expires:
Sworn to and subscribed before me this
day of
,19
Notary Public
Print Notary's Name `�. �� 1� C, "` �., (� •,r
Prepared by: P. S
I .� 6Otr Km. `l /WE_
Address: �,�
Date
WORK DESCRIPTION .tl rl
i
Job Address
c�
FEES: PERMIT 37. RADON
PERMIT APPLICA ION FOR MIAMI SHORES VILLAGE
Historically Designated: Yes No
Legal ►^ p
Owner/Lessee / T ele_ 37 Master Permit # O 97
Owner's Address ?
P hone
Contracting Co.
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Notary as to Owner and/or Condo President Date
My Commission Expires:
C.C.F.
Tax Folio
Address
Address
SIGN
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECCHANICAL ROOFING PAVING FENCE z te..)
Square Ft Estimated Cost (value)
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- n -,ontractor to do the work stated.
•
Signature of owner and/or Condo President Date Yign of Contractor or Owner- Build br Date
Notary a
Date
My Co • afPCIAL NOTARY SEAS
o <i SANDRA M MONTIEI
1 w j COMMISSION NUMSEP
��III'••� .4.* CC40126 t
�. MY COMMISSION •E.c"
OF F\. AUG. 17.19c
NOTARY C,
TOTAL DUE 113. °')
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
JUN 30 '93 9:33 MY PHARMACY
FOP/1E1C • 302 • 3010 .
Ux • 3 311 • METRO DADE COUNTY
BUILDING AND ZONING DEPARTMENT
Master ?emit Nc.
Subsidiary Per. . -Numb
Job Address or /7 N£ 0T
Date Insp..
2 .7.o•7 •
41/11Enr 46.45(,.......
pe sill nspec or
•4
Ti ic. A[.
P int Name
Oar , Mop •
APPLICATION FOR SPECIAL INSPECTOR
In, order tom aed_te the reco ion effort for the above enti ned
pecial Ins ector to pro ect I rcq�
inspections. : attest to he fact that I have b th owner'sconsent.
I understand / will performed by Building and perform all required inspections eXcept the final which will
has authorited the Special Zoning staff. However, in the case of roofing the Chief Inepec
Zoning inspection checklist Inspector to perform the final. I will follow the.Build:ng.
and will maintain an accurate log of my inspections.
SiACO
Owner's Signature
Owner's Name
Chef Inspector's Approval
Qualifications: (to be completed only if you have not prequalified.)
pLUMHINC.__F'.ErTRTr^AT M7rW),NTCAr, TRADE
I am a:
( ) Dade County Licensed Master Plumber- License No.
( ) Dade County Licensed Master Electrician- License No.
( ] Dade County Licensed Master General Mechanical -- License No.
DU'LDING AND ROOFING TRADE,
I am a:
( ) Fla. Registered Architect License No.
(x) Fla. Registered Structural Engineer License No. 3bl V'o .
( ) Certified Dade County or State Gen. Contractor /Dade County Lic.l
£XPERIF.NC:
My experience and training to perform the subject inspection(s) ace:
Work De j
1NsFtcTION ZOO
PAGE.01
St. Lic.
Spec :a. Inspectors
S_cr + Arure
Rejected
r�