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