863 NE 92 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date a ti q Job Address RP, 3 A/E
Legal Description
� ;�"Lessee / Tenant pl/ /C . (7O
Owner's Address 663
Contractin co. cry eFC / ^) C
Qualifier'. -L
State # 1. C o C7/ C o Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
WORK DESCRIPTION /Sik L t ,( ; 4i e, / cc -Gtfi- a" g Tr (a ® L P 1
Square Ft. 70
sr
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 perfonned 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 Life abbve -named contractor to do ,the work stated.
Signa
No
My
to Owner and/or Condo
onuhi ssion Expires:
FEES: PERMIT
or Condo President Date
RADON
Date
P (SY
o LIMDA A. KATZ
COMMISSION # CC470537
fo ` EXPIRES JUNE 11.1998
C.C.F.
9a s r Tax Folio / / 320 6 oD5 6D, C7
Historically Designated: Yes No K
Phone 75 F9t
Competency #
Address
Address
Address
Phone
Ins. Co.
Estimated Cost (value) / 9 5—
.4/
Signature of Contractor or Owner - Builds( Date
d 72 9/5-/y7
Notary as to Con&1ctor or Owner- Builder Date
My C c inid
Co
II. .. MY CoaMM881ON EXPIRES die OF M DEC. 17,2002
NOTARY
•
0 4 1
CC7
Electrical
305 - - 7s - 77/2_
Th
ROOFING PAVING FENCE SIGN
A'P'E
BOND
APPROVED: TOTAL DUE
Zoning Building
Mechanical Plumbing Structural Engineer
BUILDING ❑
ELECTRICAL
PLUMBING ❑
ROOFING
Owner of
Building
❑ PERMIT N° 15669
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot II BI.
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $
•
DATE 1 ° - S.} T 195
Contractor's
License No
Amt. of
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 application
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 responsibility for work
done by his agents, servants or employees.
Signed • BY
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 responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Application is hereby made for the approval of the det. iled statenien• of the plans and speciffca, ions herewith submitted for the build-
ing or o h. - ructure her i described This t-t licatic is made in compliance and con o'm ty w.th the Building Ordinance of Mia ii
Shores Villarre, or da, and all pro isions of the Laws tf the State of kkrid. all o d nances ,,f Mi m Shores Village and all rules and
regu a ion. of the Building Div.. i of ,iam Sho. iilage l '1 ,e -o. ipl.ed with, whether herein specified or not. A copy of approved
plans and specificati .m must be key • at building durin,, progress of tl.e wcrk.
Date 1/22_/5.4 19
Owner' Name and Address Chas Rakowski. No 863 Street_. ___ NE 92nd St,
Registered Architect and /or Engineer...
Name nd address of licemed contractor. L-ing _ Roofing_ and Tile __Co.,....InC. ; _ .430 N. W. _ 79th St.
? ocation and legal description of lot to be built on:
1.ot ._. _.___.._.__ .. _ Block___ ___ Subdivision
Street and Number where work is to be done_ _ .863___N..._E.___ 92nd___ St ..,___Miami__ShQr_eS- ,__F1a,___
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 Cov' ring__ Tile .
Estimated ' ;tal cost of improvements $__ 275.00 • Amount of Permit $._
Zone ^ubage required_ __. __Plan Cubage
Distance to next nearest building__ .. _ Size of Building Lot
Maximinn live load to be borne by each floor _ . _____
hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may
be sent to . - -
The unde signed appli ant for th's building permit does hereby certify that he understands and accepts his ...litigations as an employer
of 1 bor under he Florida Workmen's Compensation Act being S- -tion 5966 Coi p led Gen al Laws of Florida P r anen S•ipplc rent,
and h s compl ed w he prov•:ions thereof, and will require s•milar comp lance from all contractors or sub - contractors emplo •ed by hint
in the wo k to be p rf med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h d public- note e
or oti.ces as are requir d by the Act. The u. d. r ign d agrees to employ only such abcontr. ctors, on work to be perforn. . der this
permit as are licensed by M am. Shores N it': ge. Lang Roofing and Tile Co., Inc.
Remarks-- - .. -- - (Signed) - __ •
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ..nd take acknowledgments, personally ap-
peared _
and who, being by me first d. ly sworn, upon oath depores and says that he is the
of th abov de.c ibed . istruction t. h has careially read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are tr le.
Permit No /6_. __ Date__ ___ ® (IS Read, Sworn to and Subscribed before me.
Disapproved __ Date__
( Signed)
Chairman
Member
Member - -.
Council Approved .._
MIAMI SHORES VILLAGE
BUILDIN INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Notary Public State of Florida
Building Inspector My Com:nission Expires.
PLANNING BOARD ___-DATE
Member
Member
Member
Date Disapproved
to me well known,
Date
N TE: A charge of $1.00 will be made for making corrections or changes to this application :ft.•r approval h been obtained from
the l dm' ng Board
A re- inspection fee of $1.00 will be charged when such re- inspection is mi.' _ necessary by improper notice fer inspe :•t' ;m or fa. Ity
i{ tcrials and /or workmanship.