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502 NE 94 St (6)c PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 01 lob Addms / 5 OoZ N �- (4 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant ]/ Janet M ; n I CID rm Master Permit # Owner's Address Phone 1 S 1 — Chi 1 / l o — x(0 Contracting Cq p t » yl,p r Address `! Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Address Architect/Engineer Bonding Company Mortgagor Address Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION o r'N \r A/a-4_ £- svu,+ '_r Square Ft. Estimated Cost (value .404N) 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. • tor or • - iti. =: AR? PUBLIC SP °TEO FLORIDA COMMISSION NO. 9 1= MY COMMISSION EXP. MAIL f Contra tor qL tAI. N It? S Signs No : as to Contra My Commission E FEES: PERMIT RADON C.C.F. • fp U NOTARY BOND 97 924r ate D o 0 Date APPROVED: s e peI /r � s' � TOTAL DUE Zoning .4 /-- :.7 Burldmg k 1 r3 p Electrical 54 h �t- Mechanical Plumbing Structural Engineer MIAMI SHORES VILLAGE 'Paint Color Approval and Agreement DATE: X // „ 7/ - / UU OWNER'S N 7)1CCa : HONE 7 7-077/ ADDRESS:,' 57) N ( SI - • i)?. S,ho ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be pai Walls IJI �a._k� iq\nvy`' V Fascia 1 c ovi^ ©' k Soffit �� _ 1 cA.c5on Roof • Flower Bins 0 X Shutters g 2,A 0'7/3 hoi-u -p Le- Sr C-€ Awnings NO hd -►-`� ®`'� el e-c g � � �,l n�'11 1 10 S c.11 Chimney / Qj e, Doors and door jams 9 Z; vn, 7�� sr) �� Glo ` Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings / Other 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. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached Sig ture of Owner Date Signature of Contractor Date * ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: S , Rif WHEN PAINTING IS FINISHED, A. a "15 CALL FOR FINAL INSPECTION 7b 0/ ,i- Building Of icial Date �I� te AIM. ON LL6E Architect Contractor or Builder Legal Description Address of Building 0 ZtI1 1! OE9/4 -C9 /22 /it rtpoc2 g 8£t££ iur 'oaioqg )w13) A laallg 16 •b• ZO!7 1L60 uo3ir *Ds lauijg e. /( a� vat BUILDING ,ti" PLUMBING ELECTRICAL ° o PERMIT ROOFING ❑ 0 Owner of r Building Pic C a.44A) ita • 9l4!h) Lot f LL6E .11 MIAMI SHORES VILLAGE, FLO�IQ! o a 11 BIT So �. �V g, V'7 sf N _ _47925 4941 :IL 40000E 90:1 Jod LP0000E901/H HOY o .v .N 'NuagsuotaaN _ S O D N / r Work to be performed under this Permit Q.`v Contractor's License No. � pq� Permit: Subdi 6J6 ZPS/ -37 CCF: O f7i Notary: vision I1 - 3 /, Ql � Bond: nd: Sq. Ft.: Radon: ./� Value of yy n Amount of / �E� Project $ oC [J Permit: IQ 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 applica- tion berefor 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 respon- sibility for work done by his agents, servants or employees. Signed- i � �-- '. .--'t � ` 3/4 V (INSPECTOR) BY In consideration of the issuance to me of thislermit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertainin: and in rict confor with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. l thi. . it assume- sibility for all work done by either, myself, my agent, servant or employee. ( , f BY AUTHORITY Date Type Insp'n ' Permit No. - -�� - A t c- 5 Name Address 5 At q ' /: " Company Phone # 3 DS ( • D 9 / / For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time 9 Name & Date dja___ZZ/