295 NE 94 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date // 2 y/ 9 ?Job Address 2S A3 E g 1 cr.. • Tax Folio
Legal Description Historically Designated: Yes No X
Owner/Lessee / Tenant Ye I a- :3 e.,,
Owner's Address Sa-r3``� Phone
Contracting Co. Address
Qualifier SS#
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company
Mortgagor Address
WORK DESCRIPTION
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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.
an or Condo
President of ovfier ent Date
Aim (4./4
Notary as to Owner and/or Condo resi
My Conunission Expires:
FEES: PERMIT
APPROVED:
Buildin
Zoning g
Mechanical Plumbing
; /may5
Signature of Contractor or Owner- Builder Date
///@
Date Notary as to Contractor or Owner - Builder
My Commission Expires:
„0p.9.Y PO9 OFFICIi', NOTARY SEAL
O- BARBARA ANN FUGA;:_I
.{1 COMMISSION NUf /7SE
`1" Q CC360191
7 J� " ^,,/ 0 MY COMMISSION EXP.
OF F \ %A!1 r, ?p loop
RADON C.C.F.
Master Permit #
4497
75y - S 76 3
Phone
Date
Electrical
Engineering
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 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.
/
p n Datpe/' ! f . 19
V Ow'ner's Name and Address ( V t L t'7 f G vv Ce / v✓ (� i / Na vZ 9.7 Street_____ 4 / r � r
Registered Architect anchor Engineer
/Name and address of licensed contractor
// Location and legal description of lot to be built on:
Subdivision
Lot qZ, -`' rr13
Street and Number where work is to be done
work to be done and purpose of building (by floors), state exterior c ors (sub samples)
and for no other purpose.
New Building Remodeling
'Ib be constructed of / �Kind of foundation
m ated Total cost of improvements s 10 l� !Lf
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor
1 hereby submit all plans and specifications for said building. All notices v
The undersigned applicant for this building permit does hereby certify that he unt _ ..vr,nnrn-
Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanen 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 pos- 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 agtees to employ only such ..contractors. 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
(Signed)
Block
} SS.
Date
w° sr
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Addition
r/
Repairs No. of Stories
,° Read. Sworn to and Subscribed before me.
Notary Public. State of Florida
Roof Covering
to me well known.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship.
STATE OF FLORIDA,
COUNTY OF DADE. J
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.
rt r / Date....l�!_.L J[� ) ' ' / J K? 19
Owner's Name and Address._ J. No 1 j 5 Street. l/ & 9
Registered Architect and /or Engineer ����Qj,,__������-
Name and address of licensed contractor -_fir e CC -P1 -1Y
Location and legal description of lot to be built on:
Lot Block C Subdivision
Street and Number where work is to be done .I Sr
State work to be done and purpose of building (by floors) 0 0
•
„4.11
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
l
Estimated Total cost of improvements $_. 1'!,P 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, Pennanent 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) .. _.::. : _. ___ _ _ _ (1 i tg/4
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.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
Building Inspector 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.