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135 NE 94 St (21)BUILDING ELECTRICAL PLUMBING ROOFING r: Owner of Building MIAMI SHORES VILLAGE. FLORIDA 0 ❑ DATE 195 ❑ PERMIT N° 382 Contractor's License No. Work to be performed under this Permit Architect Contractor or Builder Legal Lot Description Bl Address of Building CONTRACTOR OR BUILDER Subdi- vision Value of Project $ Amount of Permit $ 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with 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 responsibility for work done by his agents, servants or employees. Signed' _ 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 strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY e ti. r . i 1 4 B t 'r 7 1 It r t r,.i th`materi'a 'opdsa to tjsh e hereby pr # prr ,may', 4� : i � r y '' r . : • We ' Is' a r d; S o'(t' tPie "lab r n sary sots the c0mp3eb4h 01 r erf 4 !4 . '. c4:$3.6— ��y.�y .., r ..... „ Q4 a;; o r1't ,�1"TG1 - .. M� 1'r, t ,.. ._ NO. (v) /4 12)°°`) All material is guaranteed to be as specified, submitted for above work, an ornpl Ova 1.A...ifx.r" ai r ‘+- and the above work to be performed in accordance with the drawings and specifications ed in a substantial workm nlike riner for the sum of a -c4 i Dollars ($ S 7 C ° ^v ) with payments to be made a follows: Any alteration or deviation Iron above spedtications Will be executed only upon written order, and will over and above the estimate, An agreements contingent cidents, or delays beyond our ccntrol. / 4 5 .rte ,.` ✓ . • Respectfully submitted rnvoiving extra costa • . b@COrne an e:cua charge Per E9 tA V ti Po c1 -R 4)vQ 1 M r - upon strikes, ac. Note • This proposal iiiWie withdrawn by vs if not accepted within days. NAME . .. , ADDREt3S Nt.t F ._ NO. (v) /4 12)°°`) FROM : RIOLFI ELECTRIC INC. PROPQSAL so- L... c- , CAL Qtr s , et ti C cr.. o <-'.\ oOOQ 5 k 3ag5 Akla s-r ) 443 -SESo tA'+-A t ?' ,. 3316 PROPOSAL SUBMITTED TO: 9EpT00 OFP'ROPOSAL 7tae above pnees Spvcitii;t3tlone and cundltlons:are sattstactory.ehd_are hereby accepted You are authorized t'o do the•work as specified: Payrrtehts will be rnade as outlined;above; Date 08118 .eon; MADE IN USA FAX NO. : 305 740 9029 DATE OF PLANS r / Signature � � L7 w qVcol ' Signature PROPOSAL WORK TO BE PERFORMED AT: Nov. 08 2004 07:53PM P1 ARCHITECT ADDRESS . Bonding Company's Name (if applicable) Bonding Company's Address ' City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding 82500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building pennit a issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Print: Print: My Commission Expires: My Commission Expires: Chc 05/13/03 Signature Signature /mil `` Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this / day of , 20 _, by , day of fie.6 -I t t o,+-t , 20c/51 by W 401.1, r who is personally known to me or who has produced o is persona y known to m�or who has produced 1 As identification and who did take an oath. as identification,ng who CGt1 1 idit NOTARY PUBLIC: NOTARY PUBLIC r ;?° =- '•: Commission 4DD198168 : Expires: Mar 30, 2007 Sign: Sign: Sr t/� " .v '•. ..•; Q Bonded Thru tic Bonding Co., Inc. *********************** * * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * ** * ** ** * * * # ** * * * * * * * * * * * * * * * * * * * * * * * ** eel "7 APPLICATION APPROVED BY: ' Plans Examiner Engineer Zoning f " . BUILDING PERMIT APPLICATION FBC 2001 Owner's Address 115 q S City T,.1a ra.. 5 State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village is Building Historically Designated YES Miami Shores Village Building 1 a artment 10050 S Tres, Florida 33138 T : a : (31 ) 756.8972 County Miami -Dade NO ✓ Contractor's Name 6:1,1:t4 fil 44,64 j1( Contractor's Address /706 b rlll LJ 1 rt - City M i •cke State / Qualifier 'E.-% w i - $ Value of Work For this Permit Type of Work: Addition Describe Work: Notary $ Training/Education Fee $ Scanning $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Radon $ Zoning Permit No. 0 04 -1224 Master Permit No. Zip 3 3 1 3 iS Phone # 155 Nit= q J s f- Square Footage Of Work: Zip 33 i'3' Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) CO r d 0 t ell C r 0(t Phone # S 05 7 S 7 3 O / Phone # pot' G27i ,4 Zip 33O State Certificate or Registration No. ejlee)a€o -' 39. Certificate of Competency No. Architect/Engineer's Name (if applicable) 30 r512.- are 1-1 11A Phone # ['Alteration ❑New ❑ Repair/Replace ❑ Demolition d Submittal Fee $ Permit Fee $ CCF $ CO /CC Technology Fee $ Bond $ Cordinal Gordon 135 N. E. 94 St. Miami Shores, F133138 Attn: Chet Included will be: 1. Permit fees 2. All duct work necessary 3. Installation of 2 new supply vents 4. Installation of exhaust vent 5. All trash removal 1 •� Cffz Coolin_4 e . ods, Inc. Representative COOLING METHODS, INC 17060 NW 56 Court Miami, FL 33055 (305) 622 -9454. Toll Free 1- 888 - 272 -5697. Fax# (305) 622 -6924 CAC 054234 PROPOSAL We hereby propose to furnish the materials and perform the labor necessary for the installation of 2 supply vents in addition. All work will be done in a workman-like manner and in accordance with South Florida Mechanical and Building codes. Cooling Methods Inc. proposes to perform these services for the sum of $495.00. At signing of contract a 50% deposit is required, with 50% due at completion. Warranty: 1 year parts and labor. This offer is valid for thirty days from proposal date. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Customer's signature Date Date O 1 / 15 / 05 o b January 14, 2005 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2005 -20 Contractor's Address: Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: A/C Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 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 strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. `Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2005 -20 Contractor's Address: Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: NC 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 strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. %igned: (Contractor or Builder) BY: Page 1 of 1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: MC2005 -20 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: NC Signed: (INSPECTOR) Mechanical Permit Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 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 strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: MC2005 -20 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Contractor's Address: Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: A/C Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 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 strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work donepy either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATIO FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) eioe-j10 C-o e-D % M E l Phone # ( 44,9 (44,9 75^9 -- 50 /4 Owner's Address 1 J 4't 4 N / ' S i City !-t t PPM' 1 State F L-- Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Cite Qualifier $ Value of Work For this Permit Type of Work: Describe Work: Submittal Fee $ Notary S Scanning $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village ilding Department 0 .E.2nd Avenue, Miami Shores, Florida 33138 el: (305) 795.2204 Fax: (305) 756.8972 M /AM I State F'-- t 'i i1#yDG' Zq Qt/' / • , 57r '- County Miami -Dade NO X ['Addition ❑Alteration ['New Structural Plan Review. $ Permit No. 6 e'o e-/ ` (,, ( r TMasterPermit No. 8p /3r HE" 94 ST Zip Phone # Zip Contractor's Company Name .5A ELE ( frit Phone # #9j) 3'Z6 - /01 7 Contractor's Address 3 9 9 $" Sir' 4 • Zip 3 31,1 State Certificate or Registration No. Certificate of Competency No. 9 4 r 6)000 59 Architect/Engineer's Name (if applicable) 'CZ AiANTi'CL,r.7 Phone # (3» , ) /5 '-- 73 i7 Square Footage Of Work: t ec zi r ,oL e, MO .z) E7J N Icy rew&IY /VP, nQN.o c RE C-771) ctr/ j /f/ - r,- * * * * * * * * * * * * * * * * * * * * * * * ** Fees * *, * * * * * * * ** * *** * * * * **** * * * *** ❑ Repair/Replace ❑ Demolition Permit Fee $ /4 e t' CCF $ CO /CC Training/Education Fee $ Technology Fee $ Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding 82500, the applicant mush promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Cord 2-"-. 1 Or Signature Owner or Agent The foreg ing instrument was acknowledged before me t this y LUi day of , 20 NOTAR sign: Print: LIC: My Commission Exp res: who is personally known to me or who has produced b �-� 61--107-91-5154f J-3 As identification and who did take an oath. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 :4 e4 4. ontractor The foregoing instrument was acknowledged before me this 2 day of © l- , 20 Oq, by e✓ • »q w r.• who is personally known to me or who tias O t� ed : • as. dep , , i °1 df t ( an oath. NOTARY PUBLIC: • l' %Cc -=ynE; . 12 1(1 { Corrrr.:2cn CL 310 t � _finnyHstI6 Commission feli!d23870 Q`- Expires: May. 26,08 Bond commission Expires: Atlantic Bonding Co., Inc. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** e"li 2 / Plans Examiner Engineer Zoning Date Legal Description Historically Designated: Yes Owner/Lessee / Tenant & t I d Deek Ramo., m Owner's Address l 3,5 / v d £ 94.51 - --' Contracting Co. fs —I r l C C Qualifier r tit n a a{ -en , State # ,o ©Ca g Municipal # co y\Je n p er (4v\\ �P PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /35'N,6,9 Tax Folio Signature of owner an Or Condo President Datd otary as to Owner and/or Condo President Date My Commission Expires, FEES: PERMIT ' C C.C.F. APPROVED: Zoning Mechanical GtDar' Building Master Permit # Phone Address 1 c t3 / V E. ) .� SS# ( Q-773 Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILD y EL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ��'U✓ 1 CO S Y\1\, ��U1 � 'C \ c;) `' v im Square Ft. Estimated Cost (value) .36a, 0 9 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. OWNEW AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable ating cons / 'on d zoning. Furthermore, I authorize the above- e c ntractor to do the work stated. ,aX/14/(„tve, Signature o5Contractor or Owner- Builder Notary as to Contractor or Owner- Builder My Commission Expires: �} Ri r'. ✓� =■€E&CIAL NOTARY SEAL O ` {• scorn W DAVIS ;c ':�� L:OMMISSION NUMBER CC255237 1,s < IY COPAMISSION EXP. t''' 26,1997 NOTARY s TOTAL DUE Electrical No 39 YD fJ J i /1r1C C 1 d Date Date Plumbing Engineering Date b - (4 - / ‘ Job Address Legal Description PERMIT APPLICATION FOR MIAMI SHORES VILLAGE O w n e r / L e s s e e / T e n a n t � t ! 1 c e d M a j O r OS Owner's Address 13s N E 9j t Contracting Co. Gt �I W CO V • W • Qualifier RbrT V . C h r 5 ss# ( P h o n e 8 3 q state# G A C 02 6 41-( Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANICA ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. d2 Signature of owner and/or Co o President APPROVED: Zoning Mechanical Municipal # © 81 2. 3 Da e Notary as to Owner and/or Condo President Date My Commtssicm Expkres; . -7 /) FEES: PERMIT ' RADON (3S A e I4 ,3 Tax Folio if 32c' — 0 1 3 -- de9j / Historically Designated: Yes Address Master Permit # Estimated Cost (value) l 760 . Phone 7 Ye- ! 3 Lfr Address P.o. co) ( 3 3 / 1 4 1 ' 0 1 , 4 1 : 1 t Competency # Ins. Co. M4r c1 t, �! Address 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 andzoning. Furthermore, I authorize the above-named contractor to do e work stated. C.C.F. /. 0 0 rN ctor ue e 'u -1 lder Feb/my 14, 11309 BONED TMRU T rya uRANC!, tte, ner = • er () q® No u0- /?2.(4.44_ ‘./ %..9 Date i (C `, U.) Date NOTARY 5D 0 TOTAL DUE v' 4 0 C' Building Electrical Plumbing Engineering Owner's Name and Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE 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. • Name and address of licensed contractor - :(�L_C G �.1= ' � `' ) 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 (by floors) "�' and for no other purpose. New Building v Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering �> ! 0 (i 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 ch subcontractors,- on work y),be performed under this permit, as are licensed by Miami Shores Village. f ----7. Remarks (Signed) '~ 4 Y _ 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 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 Date BUILDING INSPECTION DEPARTMENT (j\ -a. -6 Disapproved Date_ ( Signed) ..i� Building Ins Vtor Read, Sworn to and Subscribed before me. 19 to me well known, Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chainnan 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. 'I .3.-.A. \