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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.