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45 NE 94 St (15)APPLICATION FOR CER i'fCATE OF RE- OCCUPANCY hereby apply for a certificate to re- occupy the single family residence kaown as: (address) L S — ,Miami Shores, Florida_ Legal description: Lot: / 7 a)/, , ). u r i ,Bloch: 1L ,PB&PG: I 0 — 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 that any Certificate of Re- Occupancy that may be issued by Miami Shores Village, Florida, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant: Print Name: Jf9 Application Fee (S50) Paid: Cash: Date: l`" Number: c Inspection: By: / Approved: D enied:_Date: 9 Comments: ar--A ******************_*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For the purposes of conducting the inspection required by Section 902 of the Miami Shores Development and Zoning Code, contact: Contact Name: Telephone: �' 3 " & / ' ( c 1,�-�v � Gs�-L ,��� � Buyer. Seller. Company Name: e . CERTIFICATE OF RE- OCCUPANCY On behalf of Miami 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 Mg • S VILLA FLORIDA By: Date of Certification: THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED 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- FAMJLY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CER'I UI ICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR 0'i HER STRUCTURES ON 'THHE 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. Architect Contractor or Builder Legal Description. Address of Building Lot n PERMIT 'N? 13028 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building I II n Work to be performed under this Permit CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Bl. Subdi- vision Value of Project $ DATF 'i 7 , y 195 Contractor's License No 1 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 John PAID BY d Olaii Nelson PAID - 2 YEAR ANN ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER ADDRESS 45 N.- • 94th St. LEGAL 17 -t 18, M Sec.' RECORD GARBAGE TAX BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT 'N° 12990 [1 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE License No 9. :z '40 Contractor's 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 assume responsibility for all work done by either, myself, my agent, servant or employee. il i ::(010 CONTRACTOR I c BUILDER ,f BY AUTHORITY .f° 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 b)' Owner's Name and Address 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. Registered Architect and /or Engineer MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Name and address of licensed contractor ®; Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done Y4 Al ' f% • g State work to be done and purpose of building (by floors) / ci f 4407e, Rri#' .0 < ' c» o z2 e v Gz itJ CL g / -xler Permit No Disapproved (Signed) 5‘ Date Dat L Date C , 19 1 L . D °gr _ No Street TL r �(a's Ri1 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 Su 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 are required by the Act. The undersigned agrees to employ only such sub tor; on �`. o bepermed under this permit, as are Licensed by Miami Shores Village. e / 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 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. Notary Public, State of Florida Building Inspectef My Commission Expires B 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 V. Nelson PRESENT ADDRESS 370 N.E. 107th St. LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 45 W.E. 94th St. LOT 17-w.118 BLOCK 4 SUBDIVISION i:aS Sec .1 GENERAL CONTRACTOR Joe Cherney ADDRESS PHONE NO. LICENSE NO. 9 Q BUILDING PERMIT NO. 12990 DATE .32..5.". [ J PERMIT FEES 1 7. 00 7.'}y-Ji ) UILDEV & �j-..ii _ 2 Na l•4 DATE ZONE REQUIREMENTS 20,000 CU. FT. PLAN CUBE 20,518 CU. FT. EST. COST 5 13,000 DRAW NGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY DATE $ NEW CONSTRUCTION T YPE CBS STORIES 1 ROOF CONSTRUCTION tile INTERIOR CONSTRUCTION oak and terrazzo floors,plast 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. e , , ISSUED ., t BY ✓✓ - // TO - — BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE er INSPECTIONS '1/4 HATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION Z}/ J . FEE TEMPORARY SERVICE $ BEAMS & LINTELS 4• It ' (11 T / $ / �b SEWER / FRAMING - / 3- - " ' $ GAS $ $ INSPECTIONS FINAL r i - a3 --5a sE34. BY RE- INSPECT BY ROUGHING CLEAN-UP \^ �/ x` t1 GAS CONTRACTOR ' T'Ydstik , ,Q`� 1/ ■ PHONE PERMIT NO. VIO ? -( i I DATE , -7 ' J Z FEE $ J/ °7J NEW BLDG. ALTERATION ADDITION L REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK 1,1 oS /s? / $ / �b SEWER / $ /// SOLAR HEATER $ GAS $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING . 2_ Q- .51_ \^ �/ x` 1 ^,.Cq,,,,r..•� L1 GAS 54., "'''' . SEWER SEPTIC TANK 5c - Q --St Eta SOLAR HEATER FIXTURES '7- -S . M • CONTRACTOR L,1� PHONE PERMIT NO. I . 31 1 4 Q DATE , ' - FEE $ 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 B RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE r 6 K1, `� \^ �/ x` 1 ^,.Cq,,,,r..•� L1 ROUGHING 54., "'''' . H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL -/- a 1 -- ) - 1 , 1 10' 13 UIL4I14G CSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE 1 l ', y BY 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 atiilding during progress of the work. Owner's Name and Address._. Registered Architect and /or Engineer Name and address of licensed contractor.._ Location and legal description of lot to be butffon: Lot Block Subdivision Street and Number where work is to be done Permit No Disapproved (Signed) a�- Date ,'g- T Dat Building In tor MIAMI SHORES VILLAGE 419,a32 Date �+ No , 3 Street. d I K Q State work to be done and purpose of building (by floors) Chairman Member Member ...._ . Member Member Member and for no other purpose. New Building Remodeling Addition Repairs /'k/ -a, No. of Stories To be constructed of Kind of foundation Roof/ overing Estimated Total cost of improvements $ _ .60 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) �.�.t�__a __, STATE OF FLORIDA, 4 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. PLANNING BOARD DATE Notary Public, State of Florida My Commission Expires 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 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. t" Date- -- SE P T 2 "7 / 9 6 8 j � �/ .,19 Owner's Name and Address ii -- _r_ ___________ No 45 Street_ _47� 9I- .7" Registered Architect and /or Engineer 11 0 Name and address of licensed contractor A Ma s g/li .,Q_6 ae kl2 ___feyc 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) quil.c.ltaa' <r" Ae_ /Pei_g_____ and for no other purpose. New Building 5 Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ - Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building 7 ___ . 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 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) __ STATE OF FLORIDA, COUNTY OF DADE. j 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 tree. Permit Date — Read, Sworn to and Subscribed before me. Disapproved // Date_ ( Signed) Building Inspector to me well known, Notary Public, State of Florida My Commission Expires PL INC 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. fir grav E- gle sr AsP11 L ,&v € MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement in ine 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 pregreu of the work. � Date......_.. j . 7� ° 2 8 .��....._ .19"t- Registered Architect and /or Engineer.•.. • •et.IL . :.:.. ,..•••,,. •:...�,..,,..•.• Name and address of licensed contractor....t5O ,AY4L. 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 Vii /.Q /A') Owner's Name and Address .Da` 1 e STATE OF FLORIDA, t . COUNTY OF DADE. l ss. Building Inspector Date .1 '" 1 I. PLANNING BOARD DATE Citair:nan Member Member Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to the Planning Board. A re- inspection fce of 51.00 will be charged when such re inspection is made materials anei /or workmanship. __........... for no other purpose. New Building Remodeling Addition Repair, No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $••• 00 Amount 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 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, Penn:ene•nt Supplement, and has complied .eith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint in the work to be performed under this permit; and will post or cause to be posted for inspection orr the site of the work such public notice or noticcs as are required by the Act. The undersigned agrees to employ only such s ntractors oq ha to be performed under this pcnnit, 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 Notary Public, State of Florida My Commission Expires _._. 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 .. Disapproved (Signed) Read, Sworn to and Subscribed before me. Member Member _......_..._.�...._....._ Member Date this application after approval has been obtained from necessary by improper notice for inspection or faulty Application is hereby made for the approval of the detailed sintc,,,enr ur me plans and specifications herewith submitted for the build ins or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and nII 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... ?" 7 ' _ _ , 19 . 2C . Owner's Name and Address Alf .s..,...._ ._ Noy - r • Street -y .'�' Registered Architect and/or Engineer Q .,... .......... ....�,,,,,,..,...<.,..,�..,.,,. Name and address of licensed contractor. 15 ._ a- �... ° .. a ,f Gym ssa€._.... / _... . . ........ ci7 - O`v ? Location and lcgal ion of lot to be built on: Lot./ V t / Block . Street and Number wham work is to be done �....5 _ /%14 ... _. � . � _.. G/r _ _ — .._ __ _ ...._.__ _ Ste work to be done and purposc of building (by floors). eDt'/ ....o7. .£ 3; esG .__. x Y Estimate Total cost of improvements $ ....��'v STATE OF FLORIDA, COUNTY OF DADE. Disapproved (Signed) ss. APPLICATION FOR BUILDING PERMIT Date / Date.. _...... Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT /, ,r/.S ..f..._.. 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 $.. Zone cubage required ........... 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 labur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Smp rieurent, and has complied ssith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 pcnnit, as are licensed by Miami Shores Village. Remarks (Signed) 2 — 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 F ar r a true.. Perrnit No .._.._._'��� Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires _...._..._.._.____ PLANNING BOARD DATE Chairman Member \Ierr,ber 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 1'I.rnnir,g ]lu.trd. A re inspection fce of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. Date /o Job Address Legal Description ! v v ig 1 7 1 � i/� 4--/4p / Lessee / Tenant Owner's Address Contracting Co. Qualifier State # Municipal # Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one "� WORK DESCRIPTION � e CiG e C Square Ft. 7 Z 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 be done in compliance authorize the APPROVED: PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Signature ` c fowner and /or Date: /9 g I/5 NE 9' S7 &f/ l.- .Vde its N- F9 S7 self viie- SS# ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN certify that all the foregoing information is accurate and that all work will with all applicable laws regulating construction and zoning. Furthermore, I d .,_eantractor to do the work stated. "P . JOSEPHINE CHURCH N. a Publi . State of Ftonda Oftkppegifflon Exp. April 30, 19% e. No. CC197545 Zoning uilding�` Mechanical Plumbing Address Phone Competency # Estimated Cost(value) Tax Folio /1 JQ'6 1 / j MS'S d 7 Master Permit # 3' 7/7 Ins.Co. Phone - 966,1r 1 t Signature of Contractor or Owner - Builder Date: a Priur rype or stamp s, ' 1 % / i4,h�ii/ PPrsnp ll name of Nnr, . 1�„ }Public y'rp Not : y ai to Owner and /oioA i g � tduced I.D. Notary as to Contractor or Owner - Builder My Comnission Expires: ❑ Dtv rake an L Produced: My Commission Expires: oarh, 1:4 DID NOT Sam ° Ni ** * * * * * * '* * * * * * * * * ** FEES: PERMIT RADON C.C.F. r NOTARY TOTAL DUE 7.7i Fire Other Electrical Engineering MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT o PLUMBING ❑ . 9 613 ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER Bl. Subdi- vision Sq. Ft Value of Project $ DATE 195_____ 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 AUTHORITY