776 NE 95 St (9)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.
Owner's Name and Address . .H _Anderson
Registered Architect and /or Engineer
Name and address of licensed contractor
A P P L O C AT O N FE)
G3
nzhL-i4Ste AS(
1 Ss t/ '1-
? 1'd 'la
- Aod ?
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isanbaj uo►laadsul muna
iOZZ
INI]IN..L VdI4 JNIU'1I118
IJVTI1A SA2IOHS IN VIN
MOAMO SCEoGECS V LLA E
BUILDING INSPECTION DEPARTMENT
0
Orkin l +.erminating Co0 Inc. 1960 N.W. 27 Ave. Miami
# auuyd
,(ur.dwo )
ssa.tppV
aun'.N
t� ltw.tad
u dsul acL<L
�1rci
C J
lUOlLDDONG E EO OilOT
Date
76__NOEp_.95. St. Miami Shores
sion
►
N.E. 95 St. Miami
Nylon Tent Fumigation Vikane 18 -24 hrs. 25#
and for no other purpose.
I lition._.. ..__ Repairs._ -__ .... _ _.. No. of Stories
Roof Covering
Amount of Permit $
Plan Cubage
Size of Building Lot
ling. All notices with reference to the building and its construction may
11by certify that he understands and accepts his obligations as an employer
Section 5966, Compiled General Laws of Florida, Permanent Supplement,
milar compliance from all contractors or sub- contractors employed by him
icause to be posted for inspeytion on the site of the wo such public notice
employ only such subcoryCidetors, on work t be erform under this
(Signed)
September 4
Street
Read, Sworn to and Subscribed before me.
,19 63
}uthorized to administer oaths and take acknowledgments, personally ap-
to me well known,
ys that he is the
r foregoing application, and that he did sign the same, and that all facts
Notary Public, State of Florida
My Commission Expires
DATE
Member
Member
Member
Disapproved __._ .._ .... .__. Date
ins or changes to this application after approval has been obtained from
spection is made necessary by improper notice for inspection or faulty
Miami Shores
APPLICATION
XXXI
FAR PERMIT TO FUMIGATE WITH VI ANE METHYL BRO IDE ACRITET
App Date September 49 1963
1. Location of building to be fumigated 776 N. E. 95 St. Miami
2. Name and address of owner of premises H. Anderson Same
3. Type, size and construction of building 1 story CBS
4. Is entire building to be fumigated ?_ yes
5. If not, what portion?
6. Approximate number of cubic feet of space in building or in portion to be
fumigated 25
7. Kind and quantity of fumigant to be used and manner of application and
length of fumigation period Vikane, 18 -24 hrs. 25
14 Ft. West
9. In what manner will vents to exterior of building to be sealed
Nylon Tent Fumigation
10. Date when fumigation will begin September5 1963 Time
8. Distance of nearest building and direction from building to be fumigated
11. It is hereby agreed to station a guard on the premises to be fumigated
during the fumigation period and to post suitable placards at each entrance
to the building bearing the following words in letters at least two inches
by one inch in size: "DANGER, THIS BUILDING UNDER FUMIGATION U?ITH DEADLY GAS."
12. It is hereby agreed to make such provisions that all openings into the
building may be opened from the outside after the period of fumigation is
over and to take such other precautions as may be necessary to insure that
all of the fumigant is removed from the building before anyone is permitted
to enter.
13. It is hereby agreed to notify the County Health Department when the building
has been prepared for fumigation.
FIRM NAME ORKIN EXTERMINATING COMPANY, INC.
ADDRESS 1960 N. W. 27 Avenue, Miami, Florida
Signature of Cert fied Pest
Control Operator in charge of
this fumigation Job.
Lot
r / �Lo h D
Tier A
Name Lic.No. Add. or Phone
G& eral Contractor L c.No.
Zone Req.Cu.Ft.
Plat Restriction Checked by
To Planning Board c? t 6' / e
Re- Submitted to P.B.
Plans & Spec. Checked by
To Council
Approved Rejected
. f
Bldg. Permit No. /1/c � Date i' Fee i ! 6/ Cost //061#
Type C I ,- Stories
New Construction Alterations Repairs
Date ) 'Fee
rr n
Plumbing Permit No.
Septic Tank
Sewer
Misc t1
New Const.
2lectrical Permit
Fixtures
Heater
Motors
Miscrl
New Construction
e"--)
/VW, :? 7
Block Subdivision
No Street
Approved ,Rejected
rr
Alteration
No. LT,• 1_, Date
rr
Alteration
Building Inspection D t By Re -insp By Re -Insp By
Foundation G� - (� 1 ��
Beams & Lintels
Final
Final Clean -Up
Plumbing Inspection D
Roughing
Fixtures
Sower
Septic Tank
Solar Heater
Final Certificate
=71-Cal-Inspection Dace
Rou ding 1
Fixtures
Final
Tema 0.K0
§erv: cer00K7to Power Co
Cu.Cont.
rr
rr
rr
( �
• i
Roof
rr
i i4Eairs
C4 ° Fee
rr
rr
M
Repairs
Add. or Phone
/// By , 4
Approved Rejected
7
Mae -insp By Re -Insp By .
By rte -i.nsp By Re -Insp By
Cert�Occup.Issued
, �l
a
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Owner's Name and Address
Registered Architect and /or Engineer , '
Name and address of licensed contractor .4= 0
Loeati n, and legal description of lot to be built ow_
l
Lot____ �_r__ /' __.' r° Block
Street and Number where work is to be done
oA■B SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
AP ULCATIDN 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. ,
r �/ ° ,
r-
r
. Date
/ No Street
f �•
Subdivision, L 7c. s �_
State 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 C /9'' Kind of foundation /__2_ / ,3 Roof C overing ..f 1
_ / Estimated Total cost of improvements $ / __ Amount of Permit $
Zone cubage required �? � '' _Plan Cubage � � � `4 - 1/
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 inspection on the site of the work such public notice
o r notices as are required by the Act. The undersigned agrees to employ only such subcontr �n to performed under this
permit, as are licensed by Miami Shores Village. t' '
Remarks_ — - - - - — — --
____ (Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared __ _ - - -- — - - - - (2 ` , t i ' ' —r .. W
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 Mated are true.
_g _____ ____________ Date i Read, Sworn to and Subscribed before me.
Permit No.__
Disapproved Date
(Signed)
Building Inspector
PLANNING BOARD
Chairman
Member __ _
Member
Council Ap oved _ Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and /or workmanship.
•
My Commission Expires
,19
•
to me well known,
Notary Public, State of Florida
Membe
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
OWNER'S NAME
Mme. Kit R. 5 J mtA (-4 Fe: Li 1R-TA
PRESENT ADDRESS
o 7 7 G I4. ..9'5 s;
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
7 7 (o ki E, . `jam `5T .
INTERIOR CONSTRUCTION
5 43., 1 oM...A.L, ........ ,(Joe r
LOT
2 e �2 aj
BLOCK
4 7
SUBDIVISION
M "0.w4.k S'Aores &d. 3
GENERAL CONTRACTOR
6, c... r' A. coo ne,.
ALTERATION
ADDRESS
16. 40 5.c..). Aug
PHONE NO.
LICENSE NO.
2 (3S — (
7
BUILDING PERMIT NO. I 1 4 Si o
DATE
1
7 -3 _1 J •
, PERMIT FEE $ 4' g —
�/ BUI IL L(DER'S BOND
NO. U ° DATE ^
IN D 0 IT IO C
ZONE REQUIREMENTS
CU. FT.
\ \`
PLAN CUBE 5 ?c) CU. FT.
.� -1
EST. COST $ /O j e 470
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:
.i2. d
O P'
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
DATE
NEW CONSTRUCTION
TYPE
G Z S
STORIES
opt e
ROOF CONSTRUCTION
j ,, (e
INTERIOR CONSTRUCTION
5 43., 1 oM...A.L, ........ ,(Joe r
REPAIRS
"� n DESCRIPTION �.
# Y OL N1.- l ` y7 F7 __ .'��(�� A la ( 4-,......, r. _
ALTERATION
C®.1.0_r(24 F'S- ( /c_ c2reFf T IO s s$.n ccD,4.
� <4 $ e ar(• e� - fr den - I / � e ((-
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGF COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO.
ISSUED
BY
TO
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:
.i2. d
O P'
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
DATE
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
$
SEPTIC TANK
ROOF
3
BEAMS & LINTELS
TUB & TOP OUT
POOL
SOLAR HEATER
FRAMING
$
GAS
AIR COND.
$
FINAL
CLEAN UP
SEPTIC TANK
SLAB
SOLAR HEATER
SLAB
•
SPECIALS PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
RE - INSPECT
BY
$
SEPTIC TANK
3
SEWER
TUB & TOP OUT
$
SOLAR HEATER
H. W. HEATER CONN
$
GAS
SEWER
$
RANGE CONN.
e
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE - INSPECT
BY
ROUGH ING
H. W. HEATER CONN.
$
RANGE CONN.
TUB & TOP OUT
$
MOTORS
H. W. HEATER CONN
$
FIXTURES
SEWER
$
RANGE CONN.
S
SEPTIC TANK
SOLAR HEATER
FIXTURES & FINAL
•
FIXTURES
GAS
ELECTRICAL PERMITS & INSPECTIONS
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
RE - INSPECTI BY
TEMP. SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
H. W. HEATER CONN
$
FIXTURES
$
RANGE CONN.
S
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE - INSPECTI BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
•
CONTRACTOR
PERMIT NO.
NEW BLDG.
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
PHONE
FEE $
REPAIRS
DATE
ALTERATION
ADDITION
NEW BLDG.
ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
REPAIRS
BY
ADDRESS W.6 NE 95th st
LEGALp? /� d (o I EC®
( A zASIE TAX
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
G r schoauoo (o)
/ 9`07
/2-. v o
Oge-v
/. 9 o
4 /J9 /7
/- // .2//,
/ 4. yy
fa2,7
/0 31.'
7,.4,/ '�
,0 Q.
c /
/7.1,F
�f
!
/9
/ a. a-o
fr
r'
/3/4/ *
(��y
■ 3'- ll :
,,,,R• 6--u.,
� J
r ✓ • �i_( �� .t , r
// //
� � . / . > f •a.
rr
3- -
�,�'
/� 3/- S Q
/ 5
'
/ I
/ /' ,Yo
/ - - /� . /
/4/o / � 9 y1
/42 V
1 1 / r
/ /
5
/ /
/
ADDRESS W.6 NE 95th st
LEGALp? /� d (o I EC®
( A zASIE TAX
QDDRESS77$ LEGAL
...,- ..... z v9 �r "' RECORD GARS =AGE TAX
8 1 s 98th St
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
NUMBER
S�don� l a F P
1947 '
' i
211' S �
iz - 3 / - yam
9000
7,2 od
12-7-46
/
886
/0 yr
4: -'-' tolti - ?4 ,lw. C 0)
1 ? v r
331 - 47
/ 2-.0
JOB
ADDRESS
I NSPECTION
TIME READY
R EMARKS :
I NSPECTOR
MDAMD SHOE ES V LLAGE
BUILDING INSPECTION DEPARTMENT
APPR IICATOOlid FOR
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.
Dote truly 18 9 975 . 19..__
Mr. & Mrs. John Feurtado No
776 streee_N o E o 95th Street
Owner's Name and Address George Eo CA%t1u$
Registered Architect and /or Engineer
Name and address of licensed contractor George A. Cooney 1640 S.W. 85th Ave. 33155
Location and legal description of lot to be built on:
Lot 2 & E. 1/20f 3 Block 67 Subdivisi Ni ami Shores #3
776 N.E. 95th Street
EiiIarg Bedroon.o and remodeYBath
Street and Number when work is to be done
State work to be done and purpose of building (by floors)
New Building
To be constructed of
Estimated Total cost of improvements $
Zone cubage required
Remodeling Addition ` Repairs
C.D.S. Kind of foundation Poured Reinforced Coen
7
The undersigned applicant for this building permit does hereby certify that he under ?ands and accepts his obligations as a n 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 froi . all. ..ntractors or sub - contractors employed by him
••• 'srk to be performed under this permit; and will post or cause to be posted for ,.t�sl ction on the site of the work such public notice
•- -•u by the Act. The undersigned agrees to employ only such s� tractors, on wo to rformed under this
• - "nllaee.
MIAMI SHORES VILLAGE, FLA.
No
Amount of Permit &
_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 refeiqnce to the building and its construction may
be sent to George A0 Cooney 1640 S.W. 85th Ave. Miami, Fla. 33155
DATE
UD(LOIING P[ER(MIIIT
and for no other purpose.
No. of Stories 1
wring Cement Tile
,dinister oaths and take acknowledgments, personally op-
to me well known,
the.
application, and that he did sign the same, and that all facts
dd Sworn to and Subscribed before me.
Notary Public, State of Florida
y Commission Expires
DATE
nbcr
mbcr
amber
sapproved Date
;hanger to this application after approval has been obtained from
'on is made necessary by improper notice for inspection ca faulty
Ai>•; li,atnia: is h rt•bv :made for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
:n,; or other str :,tuft l -r,•in described. This application is made in compliant and conformity with the Building Ordinance of Miami
Slxn,•s V•illag.•, Florida, and all provisions of tic Laws of the State of 1•lorida, all ordinances of Miami Shores Village and all rules and
r.•;e'. t ons of the R:111.iii g Division of Miami Shores Village shall he complied with, whether herein specified or not. A copy of approved
phms and specifications must be kept at building during prpgress of the work.
a ,f>/lid / ,� v 2 l 14 P v 7 4' S�
Owner's Name and Address � ._ No. - -- ---- Street , -� �S
Registered Arehi :ect and; or Engineer
Name and address of licensed contractor. <--C ;77//562,4)
L, atwn and Ic description of lot to be built on:
Lot Block t9 Z .. ...._.. Subdivision...... /1!/7 / - . - _S S i % • 7r
St:eet and Nundier where work is to be done 7 ._ -...
074
State wo :k to be done and purpose of building (by floors)_
d1.074. ya - .. .litl' •
New Budding
To he c-onstructe,? of
Disc, proved _.. . .
(Signed)
`:,Gam'PLICAT@DN FOR DLNLDENL1 GREG MOT
.. Date _
Building In , ctor
MBAMB SHORES V L
BUILDING INSPECTION DEPARTMENT
/ 7 A)
?�A
Date 7 7 .2-- 19
�lL
—. ? and for no other purpose.
Addition..._ .._._ .. Repairs ... No of Stories ...
Covering
ri
Remodeling .
Kind of foundation
Es..n:aied Total cost of improvements $ - - 2.3 A,mount of Permit $
:one cuuage :et,u : :ecl .. . .. _Plan Cubage.._...
Distance to next r.c:uest bui;<.int, Size of Building Lot.
Maximums live load to b' 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 mar
be sent to . .S u✓ i 7 ! < = / � � . . . - . (. - . - . ' / -`-- -- -- - /_7�. -YO- 4j.t� !`d C.T „1 / / V
T !:c unde•rs: ;fled applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of l,}; r under ti:e Florida Workmen's C:onipcusation Act, being Section 5066, Compiled General Laws of Florida, Permanent Supplement,
has conphe;l Stith the protisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in ;Le work 0: Le ;i.rfor, :,ed under this per: nit; and will post or cause to be posted for ins )ection on the ' . of the work such public notice
or nit ces as are regime,. liy the Act. 'the undersigned agrees to employ only such b 1 'ractors, on j rk to . performed under this
as are licei,scd by bli.t Shores Village.
lac :u•a :ks (Signe
STATE OF FLOi -,IDA,
COUNTY OF DADE. Ss.
Before me, the a ndei,,gned authority, 0 notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared . ......
to me well known,
and v.ho, being by roc first duly sworn, upon oath deposes and says that he is the.
of tl.c 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 st:.ted are true.
Permit No..- -- - J Date - 7 - --5= 7 - ........... .. Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD .... - ................. .....DATE
Member
Member
Member
. . ..Date Disapproved
... Date
) . :T.: A charge of ;1.00 Will be: made for making corrections or changes to this application after approval has been obtained from
,.:c :iii :,i, 1; ,rd.
.-•. re -0. tee of SI.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
at.:..»s arai/ r workmanship.
\
1
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
7/777
hereby apply for a certificate to re- occupy the single family residence known as: (address)
/7 /NC �J S / ,1\iCiami Shores, Florida.
Legal description:
Lot: ,Block: ,PB &PG:
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
ocher st s on such property.
Appli . , : Date: / 3
Print Name: 0.-
For the purposes of conducting the inspection required by Section 902 of the Miami Shores
Development and Zoning Code, contact:
� 22.
Contact Name: ��1� /'L/ Telephone:
ft a X, z,3 :, #Xa#X3IIX3 # # #rJ #* #3 u # ##ts 7:1 ##YtXt## # ## #tt # # # #YS # #zs tt ;I Yt1:1 tttt # tc T.
Comments:
Buyer: Seller:_ Realtor: Company Name:_ //
' Applc2tion Fee (S50) Paid: Cash:_ Check: Number.
Inspection: toved:VDenied:_Date:
C3�
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.
SHORES VILLAGE, FLORIDA
ate of Certification:
THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY
HAS BEEN INSPECTED BY MIAMMI 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 - FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS
CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR
WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER
STRUCTURES ON THE 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 T ORDER TO DETERMLNE THE CONDITION
THEREOF.
Date //- �'" � Job Address - 7 Oft- l � S't - � A �� Tax Folio / IOW H //
Legal Description + e I A— to-r 6C.6c -� 10 h �c w
Owner / Lessee / Tenant J IA") � � 1-uw P 4 .E1 doe o
Owner's Address 77 C. 'J€- ct5r— Phone
Contracting Co. n: e '�� ,� -�`a / c . Address 2-036 S� 7 I S7 Tea - 7 4
Qualifier 6 - r-61c /v N�� SS# 7 — 33 — Phone 36S -y7 V -2 Z2.L
State ## Q'G 1 0 17 1 Shlunicipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): UILDIRIG/ ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION )- -d ► P -1-7 u"- 6 a-fa - 04 0 e - 7t CBSducd a. �JVL
eoJ C✓ ts�..1 G ✓ S �. Aga, O , i
i
Square Ft. Estimated Cost(value) /5, 6c.0
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.
OWNERS 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
author she a ove- ntractor do the work sta
Signa
Date:
V tary /as to Owner an • «fir =»�
y Commission Expires 1„7
a
FEES: PERMIT
APPROVED:
F ERMIFI' APIFILI1 CA IFOIR MIIAMII SII- II®IRIES VE LILAG E
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RADON C.C.F. q / NOTARY
Master Permit #'
Contractor or Owner - Builder
Notary as to ntractor or Owner - Builder
My Commission Expires: 3 9.fJ
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My Comm Exp
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Mechanical Plumbing Engineering
PERMIT NO. TAX FOLIO NO. `/! foi'6 H //7 7
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
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1. Legal description of property and street address:
2. Description of improvement:
3. Owners name and address:
17 N L-
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
5(N 1 S t Gr �.
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
S. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself „Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date 01 this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different dat- is specified)
Signature .- p er
Print O . ° ers Name Tc) 14 ,J 4
Sworn to and subscri e be ore me this /D of � �/
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Notary Public
Print Notary's Na
My Commissio
NOTICE OF COMMENCEMENT
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9385589 17 1993 NOV 12 15°04
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Address:
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STATE OF FLORIDA
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