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307 NE 95 St (8)Signedt don V of BUILDING ELECTRIC PLUMBING Owner Buil Architect Contractor or Builder Legal Description Address of Building This permit is gran r • ; to d rs cation herefor in strict ©ompl co plans, drawn s, statements or at any time if the work is n permit is tented is the regulations pertaining to the sibikty for work done by his agents, Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractoriMi Location and legal description of lot to be built on: Lot Block Subdivision STATE OF FLORIDA, COUNTY OF DADE. ss Disapproved - - - ( Signed) 2!0 Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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. RE, /l1¢inQis0 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 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, Compile • General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from :41 contractors or sub - contractor - 'iployed by him in the work to be performed under this permit; and will post or cause to be posted for spection on a -ite . ' e w• ch public notic or notices as are required by the Act. The undersigned agrees to employ only such . • . • . actors n ed under t s permit, as are licensed by Miami Shores Village. Remasks ( Signed )_ 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 true. Q� Permit No l 3 7 °� Date Z — a Read, Sworn to and Subscribed before me. 2 Date q Member Member Council Approved i9$I ®�c f�,�fic PL ING BOARD DATE Chainnan _ Member Member Member No -_Q - 7 Street 19 /� s7 (4) 7 S f - Notary Public, State of Florida My Commission Expires 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. �f PERMIT APPLICATION FOR MIAMI SHORES VII Date / Job Address ?d 7 WE. FS Tax Folio 414 t,.IS Legal Description Historically Designated: Yes /2 Owner/Lessee / Tenant a` �S / 11 AIR D Master Permit # :C),;) Owner's Address 30' i' • "1//C/ f / SyogESPhone d '3. Contracting Co. s( E t Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION PP / ,V 77 /U PR- sA /LI pi Square Ft. Estimated Cost (value) 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 of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: v0 FEES: PERMIT WO • RADON APPROVED: Zoning Buildin Mechanical Plumbing frfSlk gnature of Contractor or Owne Notary as to Contractor or Owner- Builder Date My Commission Expires: - e C.C.F. / S -49 NOTARY TOTAL DUE 64 -' Electrical uilder Date Engineering