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290 NE 95 St (9)
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 290 kJ ( CA 5 ST Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant Z- D \ �T • Master Permit # Owner's Address G CID 2 L- CS Phone Contracting Co. >( Q 0141 -\ `[ - vv L) OCT c1/4i S T1 .S Address Qualifier -1 W 6/M4W SS# Phone 255 39 State # C 140 "4 Municipal # - TicW-L2 3 Signature of owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON Competency # Ins. Co. Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN a ROOFING PAVING FENCE SIGN Address WORK DESCRIPTION L STYYlk I' (1) 1u_ 1 IT fr)O (1')0 ► 'PGNe -,6 \4\ rAck v 1 O ('f:=4 tt Square Ft. Estimated Cost (value) 2 4 00 0 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 � work will be done ompliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -name on for to do the work s of Con actor or Owner- Builder Date Pe1 20— 739 — " 0 Notary as to Owner and/or Condo President Date Notary as to My Commissiorl C.C.F. 9 0 NOTARY S BOND /�? �/ TOTAL DUE T "J , 7 APPROVED: Zoning / G� Building Electrical Mechanical Plumbing Engineering BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT ,Ni.; ;c..1101 1; ) , t.II) utade for the appro \al of the detailed statement of the plans and specifications herewith submitted for the build• inc ..r r:l er s;1 t.tnte 1 ;Iesrirbed. This application is made in compliance and conformity with the Building (hdinance of Miami Slimes \' ,;•, , , 1•1 • riil,t. at.il ..11 tdort.ions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and rel;+.la11,i.ts of the riuthltnr; Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved . plans and 31)04.11 .lt ons must be kept at building during progress of the work. Date ..._.... Owner's Narnc and Adaicss . 8 � (`� t A ••• „_ No.. s tr Rc Archttici and/or l:nbmecr . j'I .\ 0.. A 1• . 1,,.,t. t .1,••i 6 1 . 77 ....... iE. ; MIAMI SHORES VILLAGE DA, 1 .1 - 1 LJ Name and aildress of licensed contractor La•st.on .. ' nn I description of lot to be bull _ p 1 Let `7 ,. . �? ...• . .. Block c C4 Subdivision y 2.C- /gi.. d. 1/ � :. 014/C _.11 J9 1i J76t 1 S;ic.:t and Nwnber where work is to be done Z 00 K) • E c95 57 __ State Hwoik to be done and purpose of building (by floors) Fp s-• ALC L= A/C .- -.....\0 4 4 4: ) 0 ler4T®gt. ro1Z. ” To ) S Co .F. t k7. . -i..t..c.i and for no other purpose. Nc`•v But:dii• Remodeling Addition Repairs No. of Stories . ... To be ee,n.tructcd of ... . ....... hind of foundation Roof Covering Es; : ;;.atc.l Tot .l cos; of improvements $ DD i\rnount of Permit 1...•_...._.eZ9 — Zone cubage require, .. Plan Cubage Distance to neat nc..:est building Nfaau'•• `a 1,t•17 lead to be borne by each flour I iu;rbv s1.L1:,0 all the p 1 „us and epccilications for said building. All notices with reference to the building and its construction may be sc .0 to ! t; ; l+r, nt for rh;, h.ttlddig permit does hereby certify that he understands and accepts his obligations ,as an employer c;t ;., r, :r„i,; \; ut .i en's (:u;.ti,cusation Act, being Section 5966, Compiled General Laws of Florida, Perron tent Supplement, t;,e i +t:;; i• ; r. theteot, and will require similar compliance from all contractors or subcontractors napluycd by him • ;;.•;•1 •'i ,; ;,, ;, r r;,1, p1.111e ;1; and will post or cause to be posted for inspection on the site of the work s ch public• notice �; i•• iLr , \' t l ire uir•;e,slgned agrees to employ only such su ctors, o ork to be rformrd under BOARD : .. ....................._..... of Building Lot .r, r, ! Pe u the Rt,....::, (Signed). tl:1. H. ...... nnt,. tAY. •• 1. Read, Sworn to and Subscribed before me. 6 930/ r,: t..r, •;•r ;,.,.L t:,,;;,ccl lit, . a i,.miry Inahhe, duly authorized to adulinist(r oaths and take acknowledgments, pe;Am Ii; pear•. . . to me well known, n, .ri ••∎,1 ‘,:011 de : and says that he as the. ... :: ,• ,., .;,!•r• , ,,..'tuctt. ti 1,..• i,ai. ea/chili/ read the foregoing application, and that he did sign the same, end that all facts &Lrl..,1 + • a;_rtr.i sic true. Notary Public, State of Florida My Commission Expires _......... DATE l•icmher .................. Member Member ....._.... IJrte Disapproved Bite .••.'t 1;1 1 < 0,.,,; ' f,,i 01.11..11•4 c or changes to this application after approval has been nlit ;i;ce-cl lrr.in t :';; s. v;;l I,•_ , h0r wlt::u such re- inspection is made necessary by improper notice for inspection or faun./ • • P �' , 2, ' Y ' ,I,;` ( i f/ Owner's Name and Address..... ORES 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. / 4- 4 Y 49/ Registered Architect and /or Engineer Name and address of licensed contractor f Q,61 ciO A /4/..en e J ¶t ,�, t Location and legal description of lot to be built on: Lot Block Subdivision G XI Date Q'tee 3 , 19 5 No. Street__1 9 Street and Number where work is to be done ._._ Al—S r State work to be Jone and purpose of bu ing (by floors) �---- ---- - - - - - -- ----/ 1 � � --� (� ®��?l.c. --i - -'A -N. /. .il k . _/ �JIC.� -. _.f� �+ �B r r� Ai aC -. lire ��'_B•( -.� P a Cajlitt..- a.p- �C_,K�_ .( for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof over 0 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 rovisions 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 wok be performed under this permit, as are licensed by Miami Shores Village. Remarks — r Date Bui . ing Inspec LANNING BOARD (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. 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 has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are Permit No a / r Date Disapproved �/� (Signed) C� Read, Sworn to and Subscribed before me. Notary Public, State of Florida My ommission Expires DATE av� 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 1 BUILDING ❑ ELECTRICAL ❑ o PLUMBING PERMIT ❑ N • ROOFING ❑ r` Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA Bl. 8818 Subdi- vision CONTRACTOR OR BUILDER BY Work to be performed under this Permit DATE Contractor's License No / Ft Value of Project $ t-- Amt. of Permit $ , 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, y(rvant or employee. ".„ 195.. 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 specifications and that he assumes responsibility for work done by his agents, servants or employees. AUTHORITY