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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 ? ' .'--/ 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 tr � Si Da 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 ""is-4,o 3 9 gd — & 4 cs Asquith R Tys .n * * U "�' "' "" SATE Oe FLC : My Comm Exp Fire _ i. Other Zoning Building ` I l Electrical 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. 4' iFk 7 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 � �/ 7,6 - V / 37= '' y Notary Public Print Notary's Na My Commissio NOTICE OF COMMENCEMENT C.ous c o . 1. LAJ 11 191.3 CA—) I. r L Ca qf 11. . cr ftGL -10A ''..1..IPIRES i 9385589 17 1993 NOV 12 15°04 ) 33 7 Prepared b J cY6 Y tiA 7 Address: 7 .5' STATE OF FLORIDA plan C0izrn Ph COUMPr O: DADE m od i 0 AID lu a Ova CR oP Pho in Phis ofIJn on r j dam A ® ;4 C:7 air - d 1..;`J' o9'rclol Sool. NlP! Cdr,. fl,`aC; ,,,, oecoune y Co ,. dD.0 S tei/L ��l 6,V)