785 NE 95 St (2)PIER= APIFILII(CATIION IFOR MIAMI SHORES VILLAGE
Date lib 9 At, Job Address - 7 g N • Y ny 72 dY Tax Folio ( - 0 / 4 7 ( - ,Z../ 70
Legal DescriptionSf L cT / 91 ge.. ,( ?
Owner/Lessee / Tenant M D riv
'WORK DESCRIPTION
Square Ft. 353
Historically Designated: Yes No ✓
Estimated Cost (value)
Master Permit #
A ®°
: 374/
Owner's Address 79'S N• E . 9 f m sT . Phone 1S Ito - 0 . 7.7 V
Contracting Co. 113. gm) t 0 I 'IF R ®c O A. Address J SC3 0 CO. L J. / 1 $
Qualifier --ID NA) EA,)EZ et SS# g4°1 - �� - )sag 4g Li- 0 %J° . I 0
State # Municipal # Competency # // 9 9 9 Ins. Co. n� r -LAo 115) ._ U o 4S
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
?emit Type (&dlle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING IFIENCIE SIIGN
Et ®e 4 . .4_N Pitt 0' -t u (fir - R ®® .
'WARNING TO OWNER: YOU MUST RECORD A NOTICE O1F COMMIENCIEMIENT AND YOU r FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWIICIE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN IFI[NANCIINO,
CONSULT WII lI-1I 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.
Signatute of owner and/or Co o President
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT 4, O. O RADON
APPROVED:
Zoning
Mechanical
Building
6 // 611 f
Date
Signature of ontractor or Owner - Builder Date
Notary as to Contractor or Owner- Builder Date
•
my
ui , <r
Electrical
C.C.F. .. U NOTARY `9 : TOTAL DUE C
Plumbing Engineering
be sent to.
Disapproved
(Signed)
Chairman
\Icrr,bcr
Member .. ..
Council Approved
/ fr
MOAMO SHORES VOLLLA E
BUILDING INSPECTION DEPARTMENT
APPUCATOON FO A• '= ;LUOlLDOICIS PE MOT
Building Inspector
Date
NOTE: A charge of $1.00 will be made for
the Plannir... Board.
A rc•in.pection fee of 51.00 will be charged
materials anti /or workmanship.
Application is hereby umdc for the approval of the detailed statement of tile plans and specifications herewith submitted for the build •
Mg or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Flnrid.t. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the i3uileling Division of Miami Shores Village shall be complied with, whether herein specified ou not. A copy of approved
plans and specifications must be kept of building during progress of the work.
Date
Owner's Name and Address ... Q ' k 501..bie 1. 1.5. _
Registered Architect and /or Engineer
None and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
aMO NOO DiS . .._... Streets F ...T..
••t,1•! 1111ftt!1f1f•••1f1,11t,V,••
Street and Number where work is to be done
State work to be done and purpose of • iding (by floors). 4,,t4,7' _...7J�`
and for no other purpose.
New Building Remodeling Addition . Repairs No. of Stories / _
To be constructed of Kind of foundation oi Roafvering
Estimated Total cost of improvements $ 7.D. Amount of Permit R.
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
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employee
of labor under the Florida Workmen's Compensation Act, being Section 5066, Compiled General Laws of Florida, Permxnt•nt Supplement,
anti has complied Stith the rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performe 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 arc required by the Act. The undersigned agrees to employ only such subcontractors work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).-
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Member
Member
Member
Date Disapproved
making corrections or changes to this application after approval
when such re- inspection IA made necessary by improper notice
(; 8 /-S/cqo
666 0/
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 a' • t.,:-4 — e > G0/G: tC(
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.
Permit No *../5 11I Date 4J
Read, Swts to and Su ribed before roe.
r
to me well kno vn,
-� (7 G s�
j'G i T+R"+� P4I i'°"Hi,`�E..f'�P 1�13.Y•dl�l.:.
14Y
comasson £1Po I;U6 S. 98
BONDED THRU 6ft10 LI:,;I RAT;CE UL6
Date
has Bern obtained from
for inapectirvn as faulty