41 NE 95 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date S / a a (93 Job Address / 1 to6 9 S Tax Folio 1/ . 3 A O6 ) J 610
Legal Description/ /9 4 B // VS&--(1/
Owner / Lessee / Tenant / w SJ Wniah 8a416 Acs �� 9u4r4 Master Permit # iitoe g g
Owner's Address / afhi'csi /l,aJ1cs. / [gyp,. /Pd, / (lsta ri 4 #JY Phone 7 Pc] Y E7 4
M , �s. 31/3,9
Contracting Co. 0 ✓kt�t g S ® �' °�a � Jxc • Address 4L3D N. ffetf /; q .i ✓-f /iqQ . �1i1L4
Qualifier H/C44 t�•,f s -)v.‘; SS# / Phone 67o?-070 /
ccc
State # 4' 4 L4 Municipal # Competency # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Square Ft.
APPROVED:
1 -24 , 44
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * *
FEES: PERMIT_ e5lia
Fire
Zoning Buildin
Address
Address
Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION /`t /d D le 4/ it . ) /G-z /Qci v , ul /,L S o% W c6' /®' 1 e ( /7Gt L)
L%tC -te • - // �- � ✓• )/ � E✓ ✓4r c / Ci •
Estimated Cost(value) r aO
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 Contractor or Owner- Builder
Date: -//1
ota y as to
y Commission E
RADON NOTARY ScD o TOTAL DUE /O`a
Other
Electrical
Mechanical Plumbing Engineering
IF SUBSIDIARY OR REVISION PROVIDE MASTER PERMIT NUMBER HERE
LOCATION OF
IMPROVEMENTS
Job Address 4/ /) 9-f 4 Y •
CONTRACTOR
INFORMATION
Contractor No c . 0 S3 8L I.
Qualifier S.S. 0 7? S V fo 0 3/
Folio
Contractors Name Zt/e vkk Se Js- /,'amt,c/ PI'
Lot Block
Qualifier Name A 4-44 e/ rJJt-e 1 ' 1 '
Subdivision PBpg
,
Address (( 30 T / v n.-d cd/ 44. Cwto ,
Metes and bounds
City /`7J 6 , Sta G Zip 3 3 /f(7
S.N3W3AONdWI
AO MLA
[ ] New Construction on [ ] Enclosure
Vacant Land [ ] Repair
[ ] Alteration Interior [ ] Repair Due to Fire
[ ] Alteration Ex [ ] Demolish
[ ] Relocation of Structure [ ] Shell Only
[ ] Foundation Only [ ] Addition Attached
[ ] Addition Detached
Current use of property
Description of Work
Sq. Ft. .Unit Floors
Value of Work
ScIAA AIW Nd
[ ] Building
Category*
lIC"dS3� JNILSIX3
NV OA 3ONV 13
[ ] Chg Contractor
[ ] Renewal
[ ] Revision
[ ] Extension
[ ] Supplement
[ ] Reinspection
HAWN SAISNAa®
Owner
Address
[ ] Electrical
[ ] Mechanical
[ ] Plumbing
[ ] LPGX
City Sta Zip
Phone
Social Security - -
i
i
PERSON TO
PICTS UP PLANS
Name
ARCHITECT
ENGINEER
Name
Address
Address
City Sta Zip
City Sta Zip
Phone
Phone
JNIONO9
Name
MORTGAGE
LENDER
Name
Address
Address
City Sta Zip
City Sta Zip
Phone
Phone
Na. •
METROPOLITAN DADE COUNTY BUILDING AND ZONING DEPARTMENT
111 NW. 1 _STREET, SUITE #1010, MIAMI, FLORIDA 33128 -1974
PERMIT APPLICATION
(Please fill out completely)
*See reverse side for Building Category
Application is hereby made to obtain a permit to do work and installation as indicated. 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 forELECTRICAL,
PLUMBING, SIGNS, POOLS, MECHANICAL and ROOFING WORK and there may be additional permits required from other
governmental entities.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with
all applicable laws regulating construction and zoning.
WARDNINIG TO ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN_YOU PAYING TWICE
FOR IMPROVEM 0 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ATTORNEY OR
LENDER BE • E'ORDING YOUR NC if t9
National Bank of FL.
Signature of Own or Owner Agent By. LES MELTZER Signature of Qualifier
PRINT N _ �, V '� TRUST OFFICER PRINT NAME
DATE -! ICI DATE
. �, , iii. —.�'�
NOTA '4
,,sr- 1 7 . :�, � 7./. K.f s..:� I NOTARY as to Contractor
My Commission xpir - wr;ta i? CIA My Commission Expires-
l'1 "13 � Si'ATIkpl BACK FOR IMPORTANT INFORMATION
CCID `�ldk EM T NO. t.. fl�
123.01 -52 2/93
} f COQ. SSIO i VP ft MAN.3 n U�
CATEGORY DESCRIPTION
BUILDING PERMIT CATEGORIES
01 GENERAL BUILDING — COMMERCIAL
02 SUB — GENERAL BUILDING — RESIDENTIAL
08 CANVAS AWNING
10 COMMUNICATION TOWER
15 DEMOLITION
18 FENCE
19 FLAGPOLE — SATELLITE DISH
29 METAL AWNING & STORM SHUTTER
35 ORNAMENTAL IRON
48 SCREEN ENCLOSURES
51 SIGN (NON- ELECTRIC)
55 SWIMMING POOL
56 TENNIS COURTS (SURFACE PAVING)
82 WINDOWS (GF) — NEW
83 WINDOW INSTALLATION (GF) (S.F.)
84 WINDOW SCREEN (GF) (CURT WALL)
86 TRAILER TIE DOWN
87 PARKING / OPEN LOT / PAVING
88 WALK -IN COOLER
91 MARINAS
97 STAGE 2 VAPOR RECOVERY SYSTEM
ATTENTION
Please be advised that Roadway Impact Fee may be required for Building Permit categories "01" Commercial, "02" Residential,
"18" Fence, "56" Tennis Courts and "86" Trailer Tie Down.
Please complete the following if your application is for one of the above mentioned categories.
Road Impact Fee, Fee Payer Name
Address Phone No
Social Security/Tax Identification No
Please be advised that any existing or proposed Development served or to be served with a septic tank requires approval
from the State Department of Health and Rehabilitative Services (HRS).
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713. Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address:b4/` / / 9 44' �'� ,.: 5 S
4. Contractor's name and
/Mg each
5. Surety:(Payment bond
Name and address:
Amount of bond $
different date is specifie
My Commission Expires:
NOTICE OF COMMENCEMENT
TAX FOLIO NO. 1/ -32 ®b / D / ®D �p
93R261.716 1993 11RY 25 13:36
frkI
2. Description of improvement: ✓e9 D' Ti /e ✓
3. Owner(s) name and address: aA'19n l fLrd }L Q T'S 1 rr°
/■ an, 'PA 6 41-1 C t /97 • ✓ /f. airv� G '
v
Interest in property: / •
Name and address of fee simple titleholder: - ' -
6. Lender's name and address:
Signature 01 Owner /
Print Owners Name G, e
Sworn to and subscribed before me t
Notary Public /,( ,
Print Notary's Na
address: Od 7kt Sa . 1 74.; 0,i"
0. .4.
�- 3 3 / 9 -
required by owner from contractor, ij nn y) FLORIDA, COUNTY O. DAD
Uti 1 q nf1i1FY G ?i this is a Pr mn
fi.: jj i,:^ niira on oe
(vf
, , A.11 19
>;. 1. ; °$ , .; ; , �! o i , icia1 Scar.
J. 4 , 4/ 1 i \ 13' .. • 'cireuitan. o r, tan&
M! / . Glc
,a
First Union
National Bank of FL.
R
V.P. & TRUST OFFICER
d Q / P.T`
S 77 'day of / ., 7'419 93
/".-44,..( CO
OFFICIAL NOTARY AL I.
P.IDA GARCLA
zQ / a 9�0' ' -' 43oTA&.Y r'BLIC STATE OF FLORIr
COMMISSION NO. CC190104
MY CrJR1h11SS1uN LAP. MAK. 31,1 :.
' ,8 f
33i3o-
Address:
7. Persons within the State of Florida designated by Owner upon why.- notice /or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s)10 receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commercement: (the expiration date is 1 year from the date of recording unless a
Prepared / ?/ ///7 Tr (l V7Pi,)
. ' ); ..c& G / / 2 . - lr
i f 37, c / M e r, ' -�►
.Af - i •ems" 42 CC e.._4 Ire
3 3 /yO '
12301.52 2/93 ' I.