145 NE 95 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
G
/ZO Jo b Address A c 1'- Tax Folio
Date j
Legal Description
Mas
,y, � Ph
Contracting Co. C,A?'1!� /A- /'� e@ Address �v76
Qualifier
State #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Owner / Lessee / Tenant
Owner's Address /4/5
Signature o
Date:
APPROVED:
J
sleenow 764
N4 9j- S/
Municipal #
WORK DESCRIPTION L i ( 54_
Square Ft. Estimated Cost(value)
110
er and /or Condo President
Notary as to Owne , d /or C do President
My Commission ' : 4 4 • FRClALSEAL•
a = tom
*; �.1 ;,,� Michael Iwaskevrycz
W ". My Commission Expires 4/10/98
%'J��, -,, ii Commission #ic 363 6Q4
** * * 'Jj`OF * *
FEES: PERMIT <5(•(0 RADON C.C.F.
Zoning
Mechanical
Phone p - .f ‘e
Competency # 6/Y/ / Ins .Co e
rE - er2t
3, T �•
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
authorize the above -named contractor to do the work stated.
Signature Contr.ctor o
Date:
cj
Notary
My C
er- Builder
er- Builder
as to Contract
c�
LmEget H. BUCCI
Noyuy Public, State of Florida
o Commission Nc. Ct; 233627 >
� 4 of _ e My Commission Eyp`, %It 5!1211/7 i * **
Bonded Through Fla. Notary Service Cc Bonding Co. >
ftutuaauutueuuuue 76r
DUE
Fire
Buildin
Plumbing Engineering
Other
Electrical
BUILDING
ELECTRICAL .
PLUMBING—)
Architect
Contractor
or Builder
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
PLRMIT N° 4329
Work to be performed under this Permit
Owner of
Building i
Bl.
Subdi-
vision
-0 11444P r
DATE 194
Contractor's
License No.
s"
Address of ,n Value of Amt. of
Building
r Project Permit f
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 pli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance w 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 respon-
sibility for work done by his agents, servants or employees.
Signed: Ew 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 • t conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this per It I assn a responsibility; fora work done by either myself, my agent, servant or employee.
4
CONTACTOR (eft BUILDER, BY AUTHORITY
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block
STATE OF FLORIDA, I
COUNTY OF DADE.
ss.
Buildi- spector
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.
D� E
o ate 14"
Street_��
Owner's Name and Address e i " r__ 4 �� 7 6 � ) r �j
ubdivision
Street and Number where work is to be done �
State work to be done and ur ose of building (by floors)...
P P g ( Y ) � ���-- 1 - -�---
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 $ n 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
' / nn -.
�`',- i J e
be sent to � -��� �= )__� ---� ' �---- -• ----- � li �� _�
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) am' .7 °
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 h carefully read a foregoing application, and that he did sign the same, and that all facts
therein by him stated are e.'
Permit No 5 Date.. ��� Read, Sworn to and Subscribed before me.
Disapproved _ ____. Date
Notary Public, State of Florida
(Signed)
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.