440 NE 94 St (8)Owner': Name and Address
Disapproved _ _______ _____ (Signed )
Chairman
Member
Member __
Council Approved
MIAMI SHORES VILLAGE
BUILDIN' INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the det,..iled statement of the plans and specifications herewith submitted for the build-
ing or o he, structure herb described This . is made in compliance and con-o *m ty w•th the Building Ordinance of Min ti
Shores Village, :Honda, and all pro, isions of the Laws i f the State. of 1.1urid. , all'o d nances of Mi au Shores Village and all toles and
regula -ions of the Building Div.: i .i of : ,lam Sho. ihlage 1- '1 e ^o, ipl ed with, whether herein specified or not. A copy ot approved
plans and specifications must be kep at building durin progress of the wcrk
Registered Architect and /or Eri ineer _
Name ;rid address of lieen•,ed contractor ._ 0 = Z�sca
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)
/ _ 9 0 Y �1 �
oi
a ,. b 1 ( c r ,� _� and for no other purpose.
CC p iy �c __..bP '�ilC .Y° -- - v
New Building_ _ _ Remodeling.. .___ _ ... Addition._ . __ _. _.... _- _ Repairs. _ _ No. of Stories -
To be constructed of __ _ . Kind of o ndation : ___- _ __ _ Roof Covering . V
6 ∎r Estimated " ,tal cost of improvements $.. -- Amount c`. Permit $... - -.
Zone rubage required __. _Plan Cubage
Distance to next nearest building__ .. __Size of Building Lot _
Maximum live load to be borne by each floor
Date
19
No Street.
hereby submit all the plans and speciii,•ations for said building. All notices with reference to the building and its construction may
be sent to
The uncle signed appli ant for th's bulding permit does hereby certify i'iat he understands and accepts his obligations as an emplo■er
of 1- bor under he Florida Workmen's Co Act b'ng S. •t:on 63 Co: p led Gen al Laws of Florida P r anvil S -ippl, gent.
and h s compl ed w:th he prov'-ions thereof, and will require s•nular coi,in iar,_e from all contra.ctOrs or subcontractors emplo ed by him
in the wo k to be p rt med under th s pern it and ill post or cans,- to be nested for insp fo on the ite of the work su Ai public note e
or •otices as are requir d by the Act. The u. d, r igo •d agrees to employ only such . Aeon ors, on work to be .rforn. d der this
permit as are licensed by M am, Shores' it : ge.
Remarks_ _•- (Sig•ied) . __ X
STATE OF FLORIDA,
COUNTY OF DADE. j Ss.
Before me, the undersigned authority, a notary public, duly authorized to adir.nister oaths ..nd take acknowledgments, per_onall 'p-
peared -
to me well known,
and who, being by me first d lv sworn, upon oath deposes and says that he is the .. _
ot th abov. de c ibed ,struction t, • 1. has careially read the fojegoing application, and that he did sign the same, and 1) at _.'; facts
therein by him stated are tr le.
i/N� LL
Permit No _.__ ./ _ _. Date_. '.0 / Read, Sworn to and Subscribed before me.
Ming Inspector My Com:nission Expires. .._. _.
PLANNING BOARD DATE
.. Member .
Member
Member
Date Di iaj.nrry
Notary Public State of Florida
Date
NOTE: A charge of 01.00 will be made for snaking corrections e- -^hinges to this application •ft.-r : pprov al 1, s I u ' lita lied from
the Planr-ng Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is m: ncc•es,ar; b; improper notice k r insp t• i• or 1 i• ty
materials and /or workmanship.
Date Z - ` f Job Address `� 1 4/1.
Legal Description
Owner
Owner's Address / 9 O ') c. 7 `t J 1
Contracting Co. Cr,A✓t L 11_ i Ydr.� Cd..)a)77 Address L /6, o ..f L.J 7J
Qualifier / ,J 7 or' -.v°j o J SS# phone 2- G `( Z o f
State #C Cdr' S'SiMunicipal # Competency # Ins .Co
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANIC)ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / Cam,.) ,J J1i�.� &
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
Date:
My Commissio
** * *
FEES: PERMIT
APPROVED:
Lessee / Tenant H44-0 Go ,J1- /) Lit L Master Permit it 361 `6 g
xpires:
GRACE SOLTTARE
Notary Public -Stote of Honda
fly Comm' on Expire%AUG 17 * 1995
COMM ,iF CC 16869
Zonin
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Mechanical
<( 7v c oKacs rc.
Building
10 Plumbing
./
Signature of Contra ` fir or Owner- Builder
Date: /
Tax Polio //3 2a(.0o /`(O.3o
Phone 7 S G 0782-
*
*
*
**
C.C.F. `' NOTARY TOTAL DUE
Fire Other
Electrical
Engineering
,te of Florida
aunty of Dade
E UNDERSIGNED hereby gives notice that improvement will be made to certain real
operty, and in accordance with Chapter 713, Florida Statutes, the following
iformation is provided in this Notice of Commencement.
Description of property: (legal description of the property, and street address if
<S/icq
available) L- 0.0 AJ I `( JJ
General description of improvement: C014 .. - O AT �o.J,✓�!«JJ�rJS ck,ti
Owner information:
a. Name and. Address: G o L,4 L,rC
b. Interest in property:vJ.JI��
c. Name and address of fee simple titleholder(if other than owner):
Contractor:
Surety:
a. Name and Address
b. Amount of bond$
Lender: (name and address)
lax roi xo 140.
NOTICE OF COMMENCEMENT
948093583 1994 MAR 01 13:01
e
O
W
(name and address) G.4,0 LA- J' 4., (o-Q.0 i7 7'
Lt "
Persons with the State of Florida designated by Owner upon no tin es /or
other documents may be served as provided by Section 713.13(1)(a)7.,—Florida
Statutes: (name and address)
In addition tc himself, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),
Florida Statutes.
Expiration date of notice of commencement (the expiration date is 1 year frorr
the date of recording unless a different date is specified)
/14#6/ /441
Jorn to and subscribed before me this / day of '� •- -14��-
GRACE SOLITARE
Notary Public -Stole of Florida
My Commission Expires AUG 17.1995
tart' Public My Commission Ex res: COMM O C 12 6869 �_.
Si nature of Owned z/
mr v N7-v-