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45 NE 94 St (2)I , hereby apply for a certificate to re- occupy the single family residence known as: (address) Legal description: Lot: 7 56 CJ�, 1.0 r i s ,Block: /C- ,PB&PG: 10 - 7 0 I hereby certify that I understand that the zoning of the property is for single- family residential use and that it is unlawful for more than one family to reside therein. I also understand un only Certificate of Re- Occupancy that may be issued by Miami Shores Certificate does that the referenced property is being used for single- family purposes and that such Ce not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY a-p ******************__** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For the purposes of conducting the inspection required by Section 902 of the Miami Shores Development and Zoning Code, contact: Tele hone: �'7 `j ` / Contact Name: c 1 4- /d P /�-� �/ p Bu, ver. Seller. Realtor:L Company Name: e -A -X Print Name: JA--,d , - P/ Application Fee ($50) Paid: Cash: Comments: / Mani Shores, Florida Date: Number �^ Inspection: By: ! ��� Approved: ✓Denied:_Date: o f 78,5 CERTIFICATE OF RE- OCCUPANCY On behalf ofMiami Shores Village, Florida, the undersigned certifies that the property described in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such property may be re- occupied by the applicant for single -family residential purposes. MIAMI SHVILLA + • S FLORIDA By: Date of Certification. THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPEC "IED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE- FAMJ,Y DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON 111E PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION THEREOF. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT IN? 13028 Lil 0 Work to be performed under this Permit BI. Subdi- vision Value of Project $ DATE c Contractor's License No Amt. of Permit $ , 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 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 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. BY AITTHOIUTY 195_ L,., PAID BY John Nelson 3.25..52 YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER ADDRESS 4S N.E. 94th Ste LEGAL 17 -wi18 b10 4 MS Sec .1 REC DGAR AGE TAX BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building E PERMIT N? 12990 n Architect Contractor or Builder Legal Description Address of Building Lot 1 1 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA < , DATE Contractor's fr License No Work to be performed under this Permit Bl. Subdi- vision Value of Project $ Amt. of Permit $ ‘;) 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 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 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. BY AUTHORITY N 1492 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building Lot Block Subdivision Street Address 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 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 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 4k , 19 Owner's Name and Address +� V L. D R� No Street Registered Architect and /or Engineer Name and address of licensed contractor Permit No Disapproved (Signed) MIAMI SHORES VILLAGE Date BUILDING INSPECTION DEPARTMENT Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done Kr /fd• / . 9 ./ State work to be done and purpose of building (by floors) 'i , t 09070 /47 �o itJST 4C,C0 / 'J Lkisi - 7 S 4 a0 ti. ;{J• 3 2 /*-1/ 4)c 7 2 a (' re• R 1 - 0 ) /C c .L and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of f undation Roof Covering Estimated Total cost of improvements $ 00 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 Sup (element, and has complied with the provisions thereof, and will require similar compliance from all contractors or su• -co tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for ins ion o • the sit of he work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such sub t tor ;/on 1 o beper rmed under this permit, as are licensed by Miami Shores Village. ��//II �/ e � y 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 he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Read, Sworn to and Subscribed before me. Dat �� 1 Notary Public, State of Florida Building Inspectef My Commission Expires ANNING 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. OWNER'S NAME John V1. Nelson PRESENT ADDRESS 370 N.E. 107th St. LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 45 N.E. 94th Ste LOT 17.w 18 BLOCK 4 SUBDIVISION MS Sec.1 GENERAL CONTRACTOR Joe Cherney ADDRESS PHONE NO. LICENSE NO. 9 (� BUILDING PERMIT NO. 12990 [ DATE 3 - PERMIT FEE S 17.00 ' 7•.)- y- Ji 'D UILDE . O�N /7 D 3J_..z N0 ' DATE ZONE REQUIREMENTS 20,000 CU. FT. 20,518 PLAN CUBE 0 CU. FT. 1 0 EST. COST $ 39 DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: DATE I X NEW CONSTRUCTION TYPE CBS STORIES 1 I ROOF CONSTRUCTION I tile INTERIOR CONSTRUCTION oak and terrazzo floors,plastl REPAIRS DESCRIPTION walls and ceilings 2 bdrm., -2 baths - living room- porch- kitchen - garage ALTERATION DESCRIPTION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. .114 01. c ISSUED 1 ° - (' , i" BY Ad 1 TO - - -_____-, BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE r INSPECTIONS ' DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION '" dZ FEE TEMPORARY SERVICE S BEAMS & LINTELS i O /5 � s / 00 SEWER FRAMING /' ,' ` ' a S GAS 5 S INSPECTIONS FINAL '7 - >D R) BY RE- INSPECT BY ROUGHING CLEAN -UP U GAS CONTRACTOR , -.. ' . .' - . PHONE PERMIT NO. DATE - _? -'- r FEE S � / "I J - NEW BLDG. 1 ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S SEPTIC TANK /�/ Z V O /5 � s / 00 SEWER S SOLAR HEATER S GAS 5 S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING oil .. Q- c SL- GAS S - / „ --s- - N- SEWER SEPTIC TANK S -O Q SZ SOLAR HEATER CCJJ ,, , L ` �� � FIXTURES (7 --• -: --- �` R )- _ 4 1 &-v 9`b1/4' C _ CONTRACTOR - PHONE PERMIT NO. DATE r - S NEW BLDG. 1 ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE S H. W. HEATER CONN. S RANGE CONN. S MOTORS $ FIXTURES S S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING S - / „ --s- - N- H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL t-7 r- D -j - t0Y • BUILD NG i'NSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY • MIAMI SHORES VILA= GE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PE MBT 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 o 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 a', iilding during progress of the work. Owner's Name and Address.. . -. a.,c. " Registered Architect and /or Engineer Name and address of licensed contractor... Location and legal description of lot to be buiffon: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs. Kiir �r No. of Stories To be constructed of Kind of foundation RooffC overing Estimated Total cost of improvements $ -.2 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, 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 inspectio on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontr, - o . on work to b performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) -.6 p - -444../ 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. Permit No "' / " Date j ://— Read, Sworn to and Subscribed before me. Disapproved Dat (Signed) Building In.? for Chairman Member Member .- ..- . Date ,,,,�� No ,J Street...4./t PLANNING BOARD DATE Notary Public, State of Florida 19 My Commission Expires 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. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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_ .._. E P l ,,/ � Owner's Name and Address R111- /�.� _ No `�'-r Street-_iY 9,/ Xi Registered Architect and /or Engineer ftf Name and address of licensed contractor .49_0/16" S _ � X9%1/�_.� � fiv C STATE OF FLORIDA, COUNTY OF DADE. u. Disapproved (Signed) Building Inspector Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 5 , 9 `� .. State work to be done and purpose of building (by floors) 3 erei 4) New Building Remodeling Addition Repairs No. of Stories To be constructed of 'VV.— Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building C ___ 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 s contractors, on wor to be performed under this permit, as are licensed by Miami Shores Village. Remarks____ (Signed). Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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, therein by him stated ar tree. Permit No.�[_A l' S Date._ __.l — Z / Read, Sworn to Chairman Member Member PL ING BOARD DATE Council Approved Date NOTE: A charge of $1.00 will be made for making corrections the Planning Board. and Subscribed before me. 2 7 9f ,19 and for no other purpose. to me well known, and that he did sign the same, and that all facts Notary Public, State of Florida My Commission Expires Member Member Member Disapproved Date or changes to this application after approval has been obtained from 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. 5 fir /f , -ew/ Sm6' i 10 f7H *'-r L'& & Application is hereby mode for the approval of the detailed statement or one 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 ........ 8 e Registered Architect and /or Engineer ......L . .f.1.��0 Name and address of licensed contractor....trt7S .01 , /0i 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) _....1 , UE�i' /!� 4'7�om �_ ..._...__.... STATE OF FLORIDA, COUNTY OF DADE. ss. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE Building Inspector Date..._..._ 7 / °?8 .�_ ...__ .. _.. ,19.E_ t, ,. ,tt...t„•• t,,,ttt' „t,...,ti t,tt, CM!'t, _..__ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $... /3d®, Ov /!,mount of Permit S. 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 dots hereby certify that he understands and accepts his obligations as an employer of Labor under the Florida ‘N'orkinen'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 s ntractors o. j •rk to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 . . Permit No..__.. .�.. �' Date .1 X1.. Read, Sworn to and Subscribed before me. Disapproved ........_..... . ...111 .. l r D te.. ��� y� t i Notary Public, State of Florida (Signed) 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.in.pection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials and/or workmanship. Application is hereby wade for the approval of the detailed statcmenc of cne plans and specifications herewith submitted for the build ine 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 /0 t at ...;... _ Registered Architect and /or Engineer :,:,.......:: ...,,,.,,, „T .,,,,...::,::::,_. \'ame and address of licensed contractor ._�A�14..".r... 4 D i 9 ._.... /A0 .. 1` ��'�..........aT°U ¢ T e-- Location and J lcgg / al / dcscrip ton of lot to be built on: Lot / ll” l Block Street and Number where work is to be done X.s "f� ....9A1..._. SSIt _ _ Sta work to be done and purpose of building (by floors). and for no other purpose. New Building Remodeling Addition Repairs No. of Stories _ To be constructed of Kind of foundation Roof Covering Amount of Permit $..,° • Estimate 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 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, anti has complied ss itli 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. n „ Remarks (Signed) 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 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 c6 Read, Sworn to and Subscribed before me. I Disapproved % .:..... Date. (Signed) APP'lLIlCAT'I Building Inspector IAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ■ N FOR BUIL Subdivision..z1.1. v.L..AM / Chairman \fcrr,ber Member _....._......_..._._ ...._ Council Approved Date NOTE: A charge of $1.00 will be made for making corrections the Planning Board. A re-inspection fee of $1.00 will be charged materials anti /or workmanship. I G PERMIT 7 Street . Notary Public, State of Florida My Commission Expires to me well known, PLANNING BOARD DATE Member Member Member ...._ Disapproved Date or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection as faulty OWNER'S AFFIDAVIT: I be done in compliance authorize the shove -na PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date /v / Z Job Address 1 1,5" NE 9'7 ST' Tax Folio /1 ✓0'0 6 Legal Description f ; 1 7 1 Owner Lessee Tenant e Master Permit #3 Owner's Address / E < S7 Phone 7 '7 6 S Contracting Co. self - le owner Address i+ 7,g ?4 114 Qualifier SS# - - Phone State # Municipal OE Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /a. e 2t-rzf e a r Square Pt. 7 Z Estimated Cost(value) V� D 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, an 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. Signature f owner and /or Date: certify that all the foregoing information is accurate and that all work will with all applicable laws regulating construction and zoning. Furthermore, I d.s;aniracter to o t he workjtated• ' I ww� +°'" ¢.. JOSEPHINE CHURCH ' //� `tt .N a Publi State of Florida . ron Exp. April 30, 1990, X197545 Not : f y to Owner and /0E3'10o My Commission Expires: APPROVED: Zoning Print type stamp na f P . Public educed I.D. produced ❑ DID take an oath or DID Nom. tell , ** * * * * * * * * * * * * * * * ** FEES: PERMIT Si/5 RADON C.C.F. i -6-7) NOTARY .00 TOTAL DUE y3,o9 Fire Other Signature of Contractor or Owner-Builder Date: Notary as to Contractor or Owner-Builder My Commission Expires: Electrical Mechanical Plumbing Engineering BUILDING ❑ ELECTRICAL ❑ PERMIT N9 9 613 PLUMBING ❑ ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA ' Bl. Subdi- vision Sq. Ft Value of Project $ DATE = Contractor's License No Amt. of Permit $ 195 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 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 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. BY AUTHORITY