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930 NE 92 St (3)Date 9 2 " g:bob Address Legal Description / PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Owner / Lessee / Tenant �/� � ' /' 1:K,E Contracting Co. g- /_ Qualifier t . , y��� SS4 State # Municipal # Owner's Address Architect /Engineer Bonding Company Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL 'ROOFING PAVING PENCE SIGN N Estimated Cost(value) Pt. ( ) � WORK DESCRIPTION ` Zze 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 constructio authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: Date: 44/U Notary as to Owner and /or Condo President My Commission Expires: . > - - Phone Competency # /A 7 Ins.Co. Address Address Signature of C Print type or stamp name of Notary Public arson y nown ❑OR Produced I.Dr. 11 i number of I.D. produced: as to Contractor nr Os dui Id y Commission ExpiV gill) take an oath, or DID NOT take an oath. * * * * * * * * * * ** FEES: PERMIT i 30 d 19 e RADON C.C.F. l'" NOTARY S .0 TOTAL DURfC' ° APPROVED: Fire Zoning Mechanical Plumbing_ Tax Folio W 54 /./ 'WIJ Master Permit # Phone �QTef�y 2 Engineering o-'ei : 14,otary JOSEPHINE CHURCH • �('� Publ State of Ronda ,. £xp A I3Q. I196 er- Builder Other Building Electrical 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. Date..._...... S e K? Ln b. — r • -- ._ _..._.... , 19..ii Owner's Name and Address DON SPRAGUE ,,,, N 93 0 St N„ E . 9 2 S .h. e et Registered Architect and /or Engineer v... xn•.. ,. ,, mre.<- ^•sr,,, ., ..... Name and address of licensed contrOetor E. SHEPPARD ROOFING, INC: 41 N.W. 20 S. , Miami 331 2 7 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 930 N . E . 9 2 Stneet _ State work to be done and purpose of building (by floors) Red (d e Vi C e ... Rz Aa.: o.......1a..2.1.....r;.ia,.at.....At i. h.... 4.... ratg.4Lat._gnav e .. and for no other purpose. New Building Remodeling X Addition Repairs No. of Stories 1 To be constructed of Kind of foundation Roof Covering 4 p.e y it.at g n a V et Estimated Total cost of improvements $ 1 ,000.00 Amount of Permit $ 20.00 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 C. E.Sheppand Roo ir19; 41 N.W. 20 St., Miam.. 33127 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 rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hi in the work to be performed under this pennit; and will post or cause to be posted for inspection on the site of the work such public noti cee or notices as are required by the Act. The undersigned agrees to employ only such subcoj pennit, as are licensed by Miami Shores Village. Remarks (Signe Notary Public, State of Florida at large ?4y Commission Expires April 2, 1982 b.tll B Arican fi o �, Ca u ty Ccm any Before me, the undersigned authorit y, a notary � .cr pu�lcc d u l y authorized to administer STATE OF FLORIDA, COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date 9.4 Building Inspector Chairman Member Member ...... --- _._..--- _..._.�. Council Approved PLANNING BOARD Read, Swo N My Commi ssio , on work to be perf z�r _ rn t. and Subscribed before m c. i .11 ijc, State of Florida �'ar 4 ' Expires. , ,•. .. i .. r,:- .. • 5 ''::'I% .:}rN;rns DATE r„. e C,, .iodp C«. ; '°s� nY der thi oaths and take acknowledgments, personally ap- peared CSI - na.:e.... C . .....Sh-epl aAV 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 carefylly read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. .i Permit No.. , �9 Disapproved (Signed) to me well known, Member Member Member �_- 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT ROOFING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ins 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. Date..._ O et a b en Owner's lame and Address DAN SPRAGUE �_.__ ._. N 930 : .Street 92 Street Registered Architect and /or Engineer ,�. ,•,••f•If••ff -N- -Sf Name a nd address of licensed contactor C , E,. St(. E. P. .P..AR.....Ii~0S1. l C .._:_..41 ...NA.A....2.0 ... St...... M 4,4M _ 33127 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 930 N . E . 92 Stn e s ,. Miami S b o n us State work to be done and purpose of building (by floors) R E R O O F A ONE STORY RESIDENTIAL B U I L D I NG 7.29 SQUARES WITH 4 PLY FLAT GRAVEL g 3.24 SQUARES PARAPETS -90LB SLATE ON PARAPETS. and for no other purpose. New Building Remodeling..... Addition Repairs No. of Stories 1 To be constructed of Kind of foundation Roof Covering 4 .... PL . y .. FLAT GRAVEL Estimated Total cost of improvements $.. J.,.i'1 .. r J. . 4.,.!? 0 Amount of Permit & 1 5 • 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 C. E.SHEPPARD ROOFING, INC., 41 N.W. 20 St., Mdam.. 33127 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under theFlorida 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 subcontr , on work to be performed under this pennit, as are licensed by Miami Shores Village. Remarks ._ __ _ ._ _ (Signed STATE OF FLORIDA, COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared CAROL _...E......S.H.E.PPARD to me weU known, and who, being by me first duly sworn, upon oath deposes and says that he is the.. ..RO.O.E.I.NG....0 -O.NTRA.C.T 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. ge? t Date I®1' Read, Sworn to d Subscribed before me. Disapproved Date.. `¢ '5—� --- (Signed) AP3 � tc, State of Florida Building Inspector PLANNING BOARD My Commissiori '' `= c ' ti • r : .:.;;t • 3 ... 8 ?..k .C.eicricn Fim b C ;.;uutty Ccmp,: 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. 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. Date Jl / 't - 60 ,i9 Owner's Name and Address._... -C„__ _ R a_ No Street Registered Architect and /or Engineer y Name and address of licensed contractor.__ Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 9:-5 0 41° A s State work to be done and purpose of building (by floors) / "e) c7 — •(--- 9- ' A a-v-e-e 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 $ ca /■ oD Amount of Permit $ G 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 Sup )lement, and has complied with the provisions thereof, and will require similar compliance from all contrac ors or sub- contractors employe d by him in the work to be performed under this permit; and will post or cause to be posted for inspectio on the site of the work suc pblic notice or notices as are required by the Act. The undersigned agrees to employ only such subc6 t rs n work to be performed under this permit, as are licensed by Miami Shores Village. ��� Remarks (Signed) � -4)7, .� (Signed) U�` - 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 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 e. Permit No Date IV 6 Disapproved (Signed) Building nspec e Read, Sworn to and Subscribed before me. to me well known, 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.