500 NE 95 St (2)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
❑ PERMIT N? 12122
❑
Bi.
cONTRACTOR OR BUILDER BY
11
Subdi-
vision
Value of
Proj ect $
❑ Work to be performed under this Permit
Amt. of
Permit
This permit is granted to the contractor or builder named above to construct the building or to l 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 1 r r ,) _ .
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, servant or employee.
■
t ,St ." 42.4eLXV
BUILDING ❑
PLUMBING L o PERMIT N° 9376
ROOFING ❑
❑ Work to be performed under this Permit Ale w /9 • " � Z1 I ,. , 7",
Owner of A
Building / /r / S C. L fiC 4, .74 /11-41 - / 1 Z e• r e C..
/ .e • 4900
Architect
or Builder Contractor
v r i � �
or Builde t.. e, (.c , . ;, .` , ‘ 4 :.. T/ O r(, 1c2416
Legal Lot i 'Z,, Subdi
Description 1 T31 44,--
, ision /7/ et • f • • t,' / /tom' c �+
t Sq. Ft.
Address of �/ W Value of
46 Building / ' L /// Project $ 440
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 applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with am
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 pJRir3• or drawings or in the statements or specifications and that he assumes respon
sibility for work done by his agents, servants o emplo I
Signed �' ' '%"f'r' (INSPECTOR) BY
In consideration of the issuance to me of this permit I a ee to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, dra t gs, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work one by either, myself, my agent, servant or employee.
CONTR TOR or BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Date
PJ
! ' 3
Contractor's 4111031t
License No.
Amount of �..
11 Permit $
BY AUTHORITY
INSPECTIONS
DATE i BY RE- INSPECT
EY
RE- INSPECT
EY
FOUNDATION
__.
5
i7_ 7..
`.
,,
,,i,a,
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
_
SEAMS & LINTELS
$
F P 1 f-1 i,NC
S
SEWER
5
SOLAR HEATER
MOTORS
FINAL 1 _
5
GAS I
$
i
LLLAN -UP
BY RE- INSPECT
BY
RE INSPECT
BY
ROUGHING
CONTRACTOR
PHONE
PERMIT NO DATE
FEE S
NEW BLDG.
ALTERATION ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
S
SEWER
5
SOLAR HEATER
MOTORS
5
GAS I
$
i
INSPECTIONS DATE
BY RE- INSPECT
BY
RE INSPECT
BY
ROUGHING
DATE
BY
RE- INSPECT
BY
GAS
BY
TEMP. SERVICE
SEWER
SEPTIC TANK
ROUGHING
SOLAR HEATER,
H. W. HEATER CONN
FIXTURES
RANGE CONN.
CONTRACTOR
PHONE
PERMIT NO.
DATE
FEE $
NEW BLDG. ALTERATION ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
S
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
F & FINAL
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL. TO POWER CO. FOR SERVICE DATE
BY
OWNER'S NAME
R.J. Comitog-
PRESENT ADDRESS
LICENSE NO.
PHONE M
/>;‘,i'
• • JOB LOCATION (ST. OR AVE.)
474 N.E. 95th St.
LOT
BLOCK
SUBDIVISIO I
GENERAL CONTRACTOR
owner
ADDRESS
PHONE NO.
LICENSE NO.
+� QQ
BUILDING PERMIT NO. 1 333 2
p
DATE 6 -18 -52
PERMIT FEE S 6.00
BUILDER'S BOND
NO. DATE
ZONE R EQUIREMENTS CU. FT.
PLAN CUBE 1884 CU. FT.
EST. COST S 1,400
DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY:
DATE
NEW CONSTRUCTION
TYPE
STORIES
ROOF CONSTRUCTION
INTERIOR CONSTRUCTION
REPAIRS
DESCR IPTION
•
ALTERATION
DESCRIPTION
'
Y.slousie porch addn._
X
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COU IL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
C I — -- d. Sy \i -.) t - i ` 1 •
'
CERTIFICATE OF OCCUPANCY NO. 1 946
ISSUED ("). a- S3
BY Vv
TO 6 '�r,.�,e..,,,�
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
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.
Date Sept 24
19 51
Owner's Name and Address __ lir &___ Mrs ___fi___V___Vi ly _____. No Street
Registered Architect and /or Engineer _ Curtis E Haley
Name and address of licensed contractor Ede Fitzgerald & Sep
Location and legal description of lot to be built on:
Lot. 12 Block -- -_55- ____ -- Subdivision Se_4tiaa__2___ Miami ___Sher_e$
'1 I ,
Street and Number where work is to be done
State work to be done and purpose of building (by floors)_____ Dwelling , t.. _
and for no other purpose.
New Building ___.__ 3C Remodeling Addition Repairs No. of Stories 1
Kin pf foundation Bleak Roof Covering, Wile To be constructed of C B S
f7 - t, i t
Estimated Total cost of improvements $ a _________________________Amount of Permit $ . '
Zone cubage required. 1750Q _________ Plan Cubage_ 5 _ _ y , ,
Distance to next nearest building - 20 ft Size of Building Lot 50x 128.50
4. Maximum live load to be borne by each floor 0- :: `_ 4. -
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 . ____ Eds__Fitsger_a.ld___ Sea
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 such subcontractors, on . .rk to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ___ _ (Signed
STATE OF FLORIDA, I
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 h(ias carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stat are true. i
Permit No._ } 1_1 113ate x' .. Read, Sworn to and Subscribed before me.
Disapproved ,_ Date
I Notary Public, State of Florida
(Signed) - -
Building Inspector My Commission Expires
PLANNING BOARD - DATE
Cliainnan Member
Member Member
Member - Member
Date Disapproved Date
Council Approved
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.
xelUDEr
L t D A 181 E: - F t z. S 1 •8
J °' 0 S T -
14 • ° / ,qo
e t i (1 ' ' 2 ,coo
17 Fi
ieThL iLLGt R E:
LE : ILit fiEtc H _12.9 151 1 ' e - c11
1 I
LoT 12. i tlocx
'La'T
•
11
icoo.o s.
1 4 s . 2. it it
. . F_
l- UILDING PERMIT NO
DRAWINGS.
OWNER'S NAME
JOB LOCATION (ST. OR AVE.) LOT
GENERAL CONTRACTOR
NEW CONSTRUCTION
REPAIRS
ALTERATION
ADDITION
1 :'1 `_..
ZONE REQUIREMENTS CU. FT. PLAN CUBE
SUBMITTED TO PLANNING BOARD
RF•SUFMITTED TO PLANNING BOARD
s,'PMIr TO VILLAGE COUNCIL
DATE
APPROVED
REJECTED
PRESENT ADDRESS
ADDRESS
PERMIT FEE S
BLOCK
j ■ rtr,
SPECIFICATIONS. RESTRICTIONS ANDCUBE CHECKED BY
TYPE STORIES ROOF CONSTRUCTION
DESCR IPTION
DESCRIPTION
REFERRED TO COUNCIL
CU. FT.
REMARKS
CERTIFICATE OF OCCUPANCY NO. - - ISSUED BY i TO
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
LICENSE NO.
SUBDIVISION
PHONE NO.
jb Yv1,4- rBUILDER'S BOND
"' 2 �.
NN O. DATE
EST. COST $
INTERIOR CONSTRUCTION
REASONS
PHONE NO.
LICENSE NO.
DATE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
q -- a 7-1"
DATE
FEE
TEMPORARY SERVICE
$
BEAMS & LINTELS
#O *"i
0P 1I .
$
$
SEWER
FRAMING
/O ..q 5
cad.:( l
$
$
GAS
$
S
$
$
FINAL
Pa' .2i,S
%W.1
RE- INSPECT
BY
RE- INSPECT
BY
CLEAN -UP
IL
$ k
ROUGHING
CONTRACTOR . U &J 6- .6-40.„
PHONE
�
PERMIT NO. r3 57 I DATE J/ f i' 41
FEE $ •y /;
NEW BLDG. I ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
$
SEPTiC TANK
$
$
SEWER
$
$
SOLAR HEATER
$
$
GAS
$
S
$
$
INSPECTIONS
DATE
B ( Y /
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
i /.5-S1 '.((�I 11
p52 i
ROUGHING
GAS
0/4
H. W. HEATER CONN.
SEWER
1
RANGE CONN.
SEPTIC TANK
SOLAR HEATER
FIXTURES & FINAL
FIXTURES
,
' )- c
- k l
C . ( (i 0.
CONTRACTOR -(Q.L.k
PHONE
� < j .�
PERMIT NO. / OJ"� �S S I DATE J 0° V ° S J
�/
FEES 9
NEW BLDG. I ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
/A- aC,- SI
0/4
H. W. HEATER CONN.
1
RANGE CONN.
FIXTURES & FINAL
/— a.- s)-
J - ,I
a � ING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
N9 1464
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
-F 3
Owner, Agent or Tenant of Building
Lot' Block Subdivision
Street Address r '
Approved use by occupancy
Remarks.
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION
..VU 1N.. 'jjZn �ti. LEGAL I b .. jj ivy ,ec. a RECORD GARBAGE TAX
r ADDRESS
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
NUMBER
J.C.Edley 9 -26 -51
.
II:
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or i 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 progreu of the work.
7 Date..._......._._ _ __....... ,11�%
Owner's Name and Address _I eetl.L �
&el) r,5 ..,-.5
Registered Architect and /or Engineer........... ,,.,. VII ...,,,.,,,, „,,,,„,.,.,,,,,,,,,.
Name and address of licensed contactor _ _ _._...._..........
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where. work is to be done _....._.._..._._. __
sue! ✓.i��YG -/• HO Z. /4 � - ac-L6 •/146 i
4 f5 e
State work � do e and purpose of building (by floors) - .___.
and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories / _
To be constructed of Kind of foundation Roof
Estimate Total cost of improvements $ 4 . P.) Amount of Permit $...�t. . Cfr
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 tkc 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 noticcs as are required by the Act. The undersigned agrees to employ only sugh subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. f ��� %lam 'G ”—
Remuks (Sig
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 true..
pp �� . ✓� 1
Permit No.._ D
..L. 1. f ` Date -) 4 4 — � Read, Sworn to and Subscribed before me.
Disapproved Date .._.. Notary Public, State of Florida
My Commission Expires _
PLANNING BOARD DATE
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.
Application is hereby wade for the approval of the detailed statement o 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.
Owner's Name and Address - ....... /v / <��
Registered Architect and /or Engineer
�+ 7
Name and address of licensed contrpctor..,G .'
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)
peared
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR SAJILDING PERMIT
PIIANNINC BOAR*
Date
t: e / et
Notary w ublic, State of Florida
My e.3 :nr7 :..; :sic'& k a!, i^.'es -.
) A'(I<
i = r .
and for no other purpose.
New Building Remodeling. Addition repair= 4 - No. of Stories
To be constructed of Kind of founded
Estimated Total cost of improvements $
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 r,tay
be sent to
The undersigned applicant for this building pennit does hereby certify that he understancs and accepts his obligations as an employer
of labor under the 'Florida Workmen's Compensation Act, being Section 5963, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all corera.ctors or sub - contractors emploved 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 per:urmed wider this
pennit, as are licensed by Miami Shores Village. -
Remarks (Signed). Ce— Zee
Rocf Covering
< Amount of F
c- -.
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to adtnimster eat';s <: nd take a ^.knowledgreent.,, personally al).
Chairman
Member later :lbcr
Member ...... Murree,
Council Approved Date Jisrp, =ov €v
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he ie the.
of the above described construction, that he has carefully read the foregoing application, r.nc ti - al ha; a ., ,fd sign the same, said that all facts
��
Permit No m sta are true. Date / 1 Read, Swo n t0 c..rtc Subs -ribcd befo.e me.
Disapproved ` Date
(Signed) (
Builciltg Inspecto
Date
NOTE: A charge of $1.00 will be made for making correctiora, naa:rg.:s .n "`:s nx.: after a pproval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such rein ectior :gas ' by noItec fee inspection or faulty
materials and /or workmanship.
N° 1464
Lot 1 ° Block
Street Address C
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
Owner, Agent or Tenant of Building
Subdivision
Approved use by occupancy I
Remarks:
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known a s the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION
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 oz 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.
/- Date
Oix al is Name and Address _ -•- -. �.. .,-- No. Street
Registered Architect and /or Engineer _
Name and address of licensed contractor_ _ _ _ . c" ,
Location and legal description of lot to be built on:
.
Lot-
Block l
1 �'�� � _Subdivision
Street and Number where work is to be done
STATE OF FLORIDA,
COUNTY OF DADE. ss.
/V) r Sw. feat,
State work to be done and purpose of building (by floors).. 1
and for no other urpose.
New Building Remodeling._ _____ ___. Addition ._ __ Repairs No. of Stories - _ -'
To be constructed of Kind of foundation___ Roof Covering__ A'n= --?
Estimated Total cost of improvements $ - " I - Amount of Permit $ 1C -------1
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 foi said building. All notices with reference to the building and its construction may
be sent to_ -- �-- --
The undersigned applicant for this building permit doe hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sec :ion 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)
Before me, undersigned authority, a notary public, duly authorized to administer oaths and take a:knowledgments, 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 s d are true.
Permit No 3 C Date.. / Read, Sworn to and Subscribed before me.
Chairman
Member ________ _____
_--
Member .
Council Approved
Disapproved ____ _ __ ____ _ Date
(Signed) �
Building Inspector
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.
PLAN NG BOARD_
Notary Public, State of Florida
My Commission Expires__
DATE
Member
Member
Member
Date Disapproved
Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date V7 97 Job Address ,5 ' 7 't ' f . Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant ■ /Xtj*j J , 0f4/,/®,,5 Master Permit #
Owner's Address / /G' j//?1 '' .84/17/7 Phone
Contracting Co. ,4 / 'A) J /1) 7 Address I 2- / fG✓ /az 4 2
Qualifier 4 ,_l .o J7
State # Municipal # Competency # /3 3 7 / Ins. Co.
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Address
Address
SS# LPhone
Square Ft. 5 ' Estimated Cost (value) 6Z 9 Y
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.
C`1VNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be do e in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the wor stated.
Signat e of own and/or Condo President Date
Notary as to Owner and/or Condo 'rests -
My Commission Expires:
FEES: PERMIT e (e .) . RADON
Date
APPROVED:
Zoning Building tit
Signature of Contractor or O er- Builde ate
Electrical
A )96 av�_ /J
Notary as to Contractor or O er- Builder Date
My Commission Expire
C.C.F. .• ) NOTARY - BOND
TOTAL DUE
Mechanical Plumbing Engineering