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1215 NE 95 St (10)Registered Architect andior Engineer Name and address of licensed contractor 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 building 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 'j S 1 •CTee Remarks (Sign Date e53 — 6 No. I2 / StreetW 9 Location and )legal description of lot to be built on: ,/ 3 Lot .21 4 Block p V Subdivision j`' S ` / / / 5 �} '6 / $�� Street and Number where work is to be done 1 2. 1 Ni 1i 1 5 .5 tree+ .1-. L - 1 rUcr S -1 C �s -r-11 t514'`) Nom - State wor a done and pu rpose o ui li y floo state exterior c olors (submit samples) �P I �'t �% �✓� S 01 [ I "Ma 1 t An Ckt,C414 ) /Ar lc. ^ ae,tel 5e » ident citi Ago pct) 4 19 A) e As -5 o &to peo'1f ( .5-+-y CBS esi a 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 5 2 ooO Op Amount of Permit $ 1 J 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 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 obligatons 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. 19; adie- s13.1 STATE OF FLORIDA COUNTY OF DADE. ss. Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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. -v. 3fl/ Date Read. Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Notary Public. State of Florida Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge df $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andsor workmanship. Date v l PERMIT APPLICATION FOR MIAMI SHORES VILLAS ='F Job Address I o 1 ,� V' C c i"7 Sr Tax Folio Legal Description �`� (�� Owner / Lessee / Tenant v lu"1 E t GtAI `-�" `� SG( Master Permit # 3 7 s -- -e Owner's Address 12.6- S N- G 5 ' Contracting Co. Jio5E - KT Co lBrn Address / /2/w ewz_ 8P Qualifier D{/�eC� / (.OJj � - �( - Phone �� State # Municipal # "wo Competency # 1 0 g Ins.Co. Architect /Engineer Address Bonding Company M '� 1 C-(� Address Mortgagor C 111 C-C \ P I MOCTe c_ Address Permit Type(circle one): ILDING LECTRICAL PLUMBING MECHANICAL R ING PAVING FENCE SIGN K DESCRIPTION - . U12 e- c H I -FE 2-00 F APPROVED: 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 auto ize e ab.v--named contractor to do the work stated. /j) J Signat r o er,an d /or •ndo President Date , Q , ( (r ce - -mac. i2 Notary as to My Coy 441(90 fA44}sNOTARY SEAL Q e■ SANDRA M MONTIEL 2 * C COMMISSION NUMBER a iI.� Q CC401261 ** * Ti. • w j 'MY COMMISSION •E*P. f * * * * ` c OF F\. AUG. 17_.:221__j �aUIJ FEES: PERMIT C fs RADON C.C.F. President Fire Zoning Buildin Signature of Contractor or Owner- Builder Date: otary as to Contractor-or Owner- Builder 0 Phone - 75? - 717q • .r .n 4 • .\P• ; :Jo 0 g• •• MARY' SEAL O e■ SANDRA M MONTIEL A tt.,, * COMMISSION NUMBER .aU'.. Q *CC40/26 * 7 !, Q � MY COM MISSION .EXP. OF F\ AUG. 17 1908 M 1 ** E 4510 Other Electrical Mechanical Plumbing Engineering Owner's Address Contracting Co. Qualifier��fh i D State # Architect /Engineer Notary as to Owner and /or APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAC Date )fr J 41- I Job Address /A/g N q � f Tax Folio I1'3 L.Q6° 0l - Rc $° ,q � Legal Description M g s r Owner / Lessee / Tenant72 -- /2tS N q kC:G C S V? # Signature of o� d/ • i Condo President Date: (��� Condo My Comma 5 b o , l'E A. MARRERO la n •. MY COMMISSION I CC 243124 las ? 2 , .-� aj WIRES: November 24, 1996 ** * `7AtPf t a; • Seeded Thou Nolliry Public Undo/falters * FEES: PERMIT o L u RADON Zoning Mechanical c,c;€ ?Ty_ Competency # Address 46-+5 D. 3a-). t( ells Master Permit # 37/, Phone - 25 - 7 - - 7/ 7'7 0 • Ste °UL ti"1 - Phone (3 9.5 Ins . Co . /1 �"t� C, lS v Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDI ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN P P AJI C f WORK DESCRIPTION C e �d1ti Square Ft. Estimated Cost(valuej / 5 10 . o 0 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 auth 2 i.e t ab . e -named contractor to do the work s Signature of Contractor or Owner- Builder Date: 2c2e,arL__MihAvir President Notary as to Contractor or Owner- Builder •;;i; {sy'., CELESTE A. MARVERO ' :',t MY COMMISSION i CC 243124 EXPIRES; November 24, 1996 .. elfnded Thou Wiley Public UBdWII= * * * * ** C.C.F. NOTARY TOTAL DUE Fire Other Electrical Plumbing Engineering