54 NE 95 St (5)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.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Date. l
No Street
Amount
,19
Location and legal description of lot to be built on:
Lot Block Subdivision
Street end Number where work is to be done
State work to be done and purpose of building (by floors)
`4..'1!1Z 4 v ° '4 � .y , s • ` r- ' s and for no other purpose.
New Building Remodeling Addition Rephirs No. of Stories
To be constructed of Kind of foundation Roof Covering
1; ;?
Estimated Total cost of improvements $
of Permit $ - - -./ P)
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 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. j
Remarks (Signed) -s<
f
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 applicatior., and that he did sign the same, and that all facts
therein by him stated are true.
Permit No 1 0- 51 Date 1 % Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Insp
tpr
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 and /or workmanship.
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 regula-
tions 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
New Building_
Distance to next nearest building
STATE OF FLORIDA,
u .
COUNTY OF DADE.
1L1
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block — Subdivisio
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
To be constructed of_____ _______ Kind of foundation — _ —____ ____— Roof Covering_
Estimated Total cost of improvements 1-
mpro ements $ � - _______Amount of Permit $_�
Zone cubage required________ Plan Cubage
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 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 Le performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) VA-
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 / 1 i ' Date Read, Sworn to and Subscribed before me.
Disapproved _—_— ________________ —___ Date
(Signed)
Chairman
Member
Member
Council Approved______
NOTE: A charge of $1
the Planning Board.
A re- inspection fee of $1
materials and /or workmanship.
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Remodeling________________ Addition_______ — ________ Repairs__
My Commission Expires_
Dace_ -- yyz 19___
No. Street
_and for no other purpose.
No. of Stories__
to me well known,
-- Ito+ - N.
Notary Public, State of Florida
PLANNING BOARD DATE
Member
Member
Member
_Date Disapproved
_Date
.00 will be made for making corrections or changes to this application after approval has been obtained from
.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE / 1947_
ERM1T N° 5810
Work to be performed under this Permi
Architect
or \t- :: 5/L . 7
Legal Lot Bl. l
Description
sibility for work done by his agents, servants or employees.
,
Address of r"
�f ri e j _ t :1 111
Buildin g 1
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 appli-
cation 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 b.
permit is granted is the understanding that the contractor or builder named ab umes the responsibility for a thorough kno . e of the o dinances anc!
regulations pertaining to the work covered hereby whether shown on the pl aw ing die st tements or specification at he sumes respon-
Sign ; 47 -..,.I Y " By 3( r
—
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all dinances andiegalalons
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoffing of Miami SholosWilliige.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
n
CONTRACTOR OR BUILD
Subdi-
vision
Value of
Project
BY
vt.!/t/J
Contractor's
License No.
Amt. o t]� ! G
Permit
AUTHORITY
New Building_ --
To be constructed of
STATE OF FLORIDA
COUNTY OF DADE.
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 building or other ,tructure h�rric
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Law, 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 e It h. het ht r
herein specified or not. A copy of approved plans and specifications must be kept at building during progre.3s of the work.
Owner's Name and Address - it
Registered Architect and or / ngineer
Name and address of licensed contractor
Location and le all description of lot to be built on:
Lot' 7 na _1?.' —_ Block — Subdivision _Seed
Street and Number where work is to be done _ -[J(
1 SS.
_ Remodeling _ - -
9 " j
Building Total cost of improvements S CO
Building Inspector
Sy� work to be done and purpose of building (by floors). sta xterio colors (submit samples) _ llt _ _ LA*
?"
Addition
Kind of foundation -
Repairs
Amount of Permit S
Plan Cubage
Size of Building Lot
_ —. No..
My Commission Expires
Date
Roof Covering_. _
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared -
Permit No. ,e)ga Date
Disapproved Date
Notary Public. State of Florida
(Signed)
Read. Sworn to and Subscribed before me.
6/ /g ?2
a�
. Street
No. of Stories
Zone cubage required _ - ____
Distance to next nearest building
Maximum live load to be borne by each floor - - -
I hereby submit all plans and specifications for said building. All notices with reference to the building e.nd its construction may be sent to
A / VZ //S
and for no o er purpu
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florid, . Workmen
Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement. and has comelied with the provisions thereof. and will require 'imil. r
compliance from all contractors or subcontractors employed by him in the work to be performed under this permit: and will post or cause to be posted h■r inTrct inn
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only s *subcontractors. on work to 111 performed
under this permit. as are licensed by Miami Shores Village. ,(
Remarks (Signed) _ v
4
to me vu 11 knrnt n
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 fgregoing application. and that he did sign the same. and that all facts therein by him st.a d uri true
PLANNING BOARD DATE
Chairman Member
Member Member - -
Member Member
Council Approved Date Disapproved _ I1ati•
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 S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or tech icrnan,hip.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date _4' c2,?^ 7? Job Address
Af /. -CA) %41 /V, 3i
Legal Description
Tax Folio
Historically Designated: Yes
No
/ Tenant \/ C) 9ti Master Permit #
Owner's Address Phone ?6, r , 7 s
Contracting Co. C) W"(f / . Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION � � /1. / .,le c`eh
Square Ft. Estimated Cost (value) ?ki r / P
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
FEES: PERMIT ' 7O RADON C.C.F. `/t O NOTARY �
ature of Contractor or Owner- Builder Date
igohe
/ _ , lam`.6' �� ?Lr,?. J . / _,/ - y
Notary as to Owner and/or Condo President Date Notary as to Owner - Builder Date
My Commission Expires: My Commission Expires:
(/— C
R�( p �, N SEAL
T ARY
` < CC797277
7r 3 MY commission EXPIRES
I.
F�� DEC. 17,2002
BOND
TOTAL DUE
APPROVED:
Zoning Buildin:�� % }r !O Electrical
Mechanical Plumbing Engineering