490 NE 94 St (5)Name ..rid address of licensed contractor ._
Location and legal description of lot to be built on:
Lot Block..- - -
Street and Number where work is to be done.
New Building_ .. Remodeling.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Council Approved
Date__
MIAMI SHORES VILLAGE
BUILDIN' INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the apprm al of the det:iled statement of the plans and specifications herewith submitted for the build-
ing or o he: structure heron described This . t-plicatscr,, is made in compliance and con w•th the Building Ordinance of Min ti
Shores Village, Florida, and all pro. isions of the Law, c f the State of 'lurid.' air() d•nances of Mi an Shores Village and all rules and
regula ions of the Building Die : i u of : uanr Sho: illage h '1 e 0o. ipl.ed with, whether herein specified or not. A copy of approved
plans and specifications must be key at building durin, progress of tl.e work.
Owner': Name and Address r { ?- � � t� �_ No Street_
Registered Architect and /or Eineer _
State work to be done and purpose of building (by floors)
rr
C4 t . _ _._.. l ? = Y and i for no other purpose.
Addition._ _ __ .. _.._ __ _ Repairs. _ _ No. of Stories , - -
To be constructed of ___ _ . _ Kind [ of o ndati� ____ _ ___ Roof Cov 'ring . �'t '
Estimated " .tal cost of improvements $__ 1__. . - Amount c`. Permit $.. _ � _..__
_Plan Cubage_
_Size of Building Lot
Zone 'ubage required
Distance to next nearest building_.
Maximum live load to be borne by each floor
hereby submit all the plans and specili.•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 bulding permit does hereby certify i'tat he understands and accepts his obligations as an enrt>loyer
of 1- bor under he Florida Workmen's Compensation Act bung S. ton T-2163 Co s -p led Gen al Laws of Florida P r anc•n. S gent.
and h s compl ed w• :th he prov'.ions thereof, and will require s•iniiar corm ian_e from all cont .c tbrs or sub - contractors cmplo •cd by Isins
in the wo k to be p rf med under th s pern It and ill post or cau. <. to be nested for insp rop on the,.site of die work su :Is put)lic not e
or ' •otices as are requir d by the Act. The u. d. r 'go .d agrees to employ only such . ubcon�c gsrs, on /,work to be r rforn, d der this
permit as are licensed by M am. Shores ‘ il'; ge.
Remarks- ((Sig•ted)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ,.nd take acknowledgments, personally •>p-
peared
and who, being by me first d lv worn, upon oath depoees and says that he is the
of tli aboc. de c. ibed ,struction t. • I. has carefully read the fofegoing application, and that he did sign the same, and 1 a' _.7, ;acts
therein by him stated are tr ie.
Permit No._ _
Disapproved _
(Signed)
ate__
6 -
Subdivision__
PLANNING BOARD
Date
90 -
Read, Sworn to and Subscribed before me.
. Notary Public State of Florida
Iding nspector My Com:niscion Expires. _
,19
to me well known,
----- .---- ..____DATE
Chairman -- -- - Member
Member .___ _ Member
Member _ . -- Member - -- ------ --- -- - -.. -
Date Dicat.oroccd Date
NOTE: A charge of $1.00 will be made for snaking corrections or -.•hanges to this application •ft:•r approval 1, s I a rbta ned from
the Plam' ng Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is m :.,- ncces.ar) by improper notice is r imp t•.t • 01 I o ty
materials and /or workmanship.
Date Z - LL - r1 f Job Address `7 1 C J ` 7 `( 1 r
Legal Description Lf 1 0 ^i1c 7 `/ ST r rD4/ I f 14 /c Ft.
Lessee / Tenant (C---1--)47 Go Master Permit # 3 5
Owner's Address q 9 0 Phone 7S ( - 78z_
Owner
Contracting Co. C - A R Lr f 41 e" C o,.Jrr./G/ Address ( / J 14--U -
Qualifier �,J /�o.^- •r°J`o� SS# L ( `1 - of
State CR CL S '1 PMunicipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ) ROOFING PAVING PENCE SIGN
WORK DESCRIPTION y '•r fi fry C,C i T
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 an /or —Condo President
Date:
Notary as to
My Colmnissio
** *
FEES: PERMIT
APPROVED:
�c-
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
• *4 r-
xpires:
GRACE SOLfTARE
Notary Public -Stote of Florida
fly CommO on ExpiretAUG 17 * 1995
COMM # CC 126869
r - d or Condo President
Zoning
Mechanical
* * * *
C.C.F.
Tax Folio / 13 2 0 0 1 `(DJ o o
Signature of Contra � 'r or Owner- Builder
Date:
**
Fire Other
Building Electrical
i Plumbing Engineering
J s'*
lax roiio rvo•
,te of Florida
)unty 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
formation is provided in this Notice of Commencement.
Description of property: (legal description / of the property, and street address if
available) `� .'J /i 1 ` 7 ff � . S/1.
General description of improvement: Cl *4 6 -44_ 0(-T Co.J?!«JJ(r.JS ct_A,Tr,
Owner information:
a. Name and. Address: 4(_Jl-1•,42.0 co.i 1_, /1L,
b. Interest in property: F /i
c. Name and address of fee simple titleholder(if other than owner):
W W e w �
Contractor: (name and address) G,40 (�I2 f £/ �rJN.0
./770 - H—'sl ( �
C7, � d i, "
JJ X .= 6 6
Surety:
a. Name and Address
b. Amount of bond$
Lender: (name and address)
7 t4e-a -/
zf a/// 7' 9 /4 �,
NOTICE OF COMMENCEMENT
porn to and subscribed before me this / day of
tary Public My Commission E
11 ✓.' -_v
948098583 1994 MAR 01 13:01
Persons with the State of Florida designated by Owner upon. whoth n tice or
other documents may be served as provided by Section 713.13(1) 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 fron
the date of recording unless a different date is specified)
Si •nature of Owned -/
4 b
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O q Q
0
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J ti C
C,1 41 1
►---- .-- - 144 ;
GRACE SOLfTARE
Notary PubflC -State of Fiorido
My Commission Expires AUG 17.1995
r e s : COMM # CC 126869
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(1 Wes'./ li