140 NE 95 St (3)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
✓Job Address
Legal Description /Q- o2 r / C� & Master Permit #
✓6wner / Lessee / Tenant A V ARt() Auroppol
t- Owner's phone . - q �S
Address j A i\Jc � S ` "r"
.„--COntracting Co.62142 o(- G►-f- ih�
Qualifier
State #
Competency# Ins. Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one):vCBUILDIN ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION /G as o re- C1[e &h; 17 / 1- n y
(' cAor J
Square Ft. Estimated Cost✓ ;gyp,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. 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.
Signatu ' of Owne and /or Condo President
Date: / - Y�
• OFFICIAL NOTARY SEAL Z
IRMA ROMAN I
y NOOT ( li • A . i oligNeRIDA
Notar as to Owner ani /o ••
My Commission Expires: MY COMMISSION EXP. MAY 26,1994
* * * * — * -
PERMIT FEE: APPROVED:
Zoning
Mechanical
Fire
Building
SS# - - phone
Plumbing
Address
i //ice - ✓�
Owner - Builder
Signatur
Date: /-?-
Notary as to Contractor
My Commission Expires:
* *
)A-197-v
Tax Fol ioll , Ya t /3 e5 9
Other
Electrical
Engineering
OFFICAL NOTARY SEAL
IILMA ROMAN
•
ARY PUBLIC STATE OF FLQRDA
ii
S' Y R 51•N M A Y2 6 994
*
* *
APPLICATION FOR BUILDING PERMIT
State work to be done and purpose of buffding (by floors)
(Signed)
Member
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 regula-
tions 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.
D ate-=- w ___ - -�_�' r _.___�__ -� -- , 19 -r'•
Owner's Name and Address - s No. Street..
Registered Architect and /or Engineer_ l r
Name and address of licensed contractor 't
Location and legal description of lot to be built on:
Lot _i A = __ .- Block_ ;- _ Subdivision
Street and Number where work is to be done____ L '__�__
_and for no other purpose.
New Building : r __ _____ Remodeling_ ___________ Addition ______ Repairs No. of Stories___ .7
To be constructed of___ ; :_ __ _-__ Kind of foundation _ Roof Covering_L__' ____—____
Estimated Total cost of improvements $_ _____-___ _�__ �.________._�Amount of Permit $ *"�,r 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, 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.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
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. _,.°y �_ Date / 1 Read, Sworn to and Subscribed before me.
G' ` h, r�
Disapproved A _— 4_/ pte v P Notary Public, State of Florida
re
'Building Inspector /' My Commission Expires
PLANNING - BOARD DATE
Chairman Member
Member Member
Member
Date Disapproved
---
__mate
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.
Owner's Name and Address
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
t
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 regula-
tions 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.
19___. .
Street--_-
--p y,.., / 4 . ,
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
State work to be done and,purpose of building (>, y oo 4) y
) ��
_,/ _I__ , , '4�= a .. ° v t,„ ., ,.j —1�`� 'G�l : _. . . ,�
______ __ __� �____ __ __and for no other purpose.
1
New Building ___________________________ Remodeling Addition Repairs No. of Stories
To be constructed of_______________ Kind of foundation Roof Covering
Estimated Total cost of improvements $ _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
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 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.
Remarks (Signed) -
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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
Disapproved ____ ______________ Date
(Signed)
•
Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
Notary Public, State of Florida
to me well known,
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.