905 NE 95 St (3)Application is hereby sonde for the approval of the detailed statement oz we plans and specifications herewith submitted for the build •
in 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 i3uilding 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.
Date...
Owner's Name and Address 7)1,1,-- - 4,84, 0711.0 No.c
Registered Architect and/or Engineer
Name and address of licensed contractor.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
work to be done and purpose of build' (by floors)... .
CaV 1 ) )ZZ
„FT& •
New Bui!ding
4
Disapproved .... ....
(Sigoed) .
APPLOCATOON FR ELILIDLIDONG PERMOT
MOAMO SHORES VOLLAGE
BUILDING INSPECTION DEPARTMENT
Building Inspector
Remodeling
To be constructed of Kind of
Estimated Total cost of improvements $...t
Zone cubage required
foundation
Date
Remarks (Signe ...._...
tt ?I • t .. t tlIfIttg••••
Roof Covering
Amount of Permit $. *a
Plan Cubage
and for no other purpose.
Addition Repairs No. of Stories
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 t srovisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him
in the work to bc performed under this permit; and will post or cause to be posted fcg_inspection o the site of the work such public notice
or noticcs as are required by the Act. The undersigned agrees to employ only ktia oo t2rork to be rformed under this
pcnnit, as are licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and tahe acknowledgments, personally ap-
peared
to me well knowm .
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 ) Date Z Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires .....
PLANNING BOARD DATE
Chairman Member
Nlerriber Member
Member Member
Council Approved Date Disapproved Date
NUTE: A ch.irge of $1.00 will be made for makin t3 corrections or changes to this application after approval has hem obtained from
the Plannii.g Board.
A re-in \pection Ice of $1.00 will be charged when ouch re-inspection is rondo necessary by Improper notice for inspection or faulty
materials anci/or workmanship.
PERMIT' APPLICATION (CATION FOR MIAMI SHO ES VILLAGE
Date 2 / 7/ ^ / 7Job Address q 0 c ,1' Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant ( AC l /6 40 A , lI Master Permit # q O (( 3 --
Owner's Address Air 1C c0 Phone
Contracting Co. —A . l ./L / i'' C Address 9 71( .° - 5 y ,® zcr Q d rte ,
Qualifier 0 I C C27-8/ SS# 2 6 2 - 1 (5 — - 7t 2 Phone 9//
State # tC, O 2- 7 3 7 2 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (drdle o u e): 'kc {UIDLDING ELECTRICAL PLUM INC IIlECHANII ROOFING PAVING IFIENCIE SIGN
WORK DESCRIPTION
. No • as to Owner
I Commission E pyres:
FEES: PERMIT
1\ • •-∎ iLll 51 V..
MY COMMISSION EXP MAR. 263999
le bi 1 -cive
1/) <�-t
Square Ft. Estimated Cost (value) 20 0 Q ,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMIENCIEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO Y s UR P PERTY (IF YOU INTEND TO TAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN AT'T'ORNEY BEFORE RECORDING YOU 4 NOTICE OF C LMMENCEMENT.)
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and
laws regulating construction and zoning. Furthermore, I authorize the above -named
Signature of owner and/or Condo President Date
!;l/
RADON
C.C.F. /� NOTARY
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.
t all work will be done
tractor o� the w
!/
ature of Co actor o I caner -Buil
Notary as to Contractor or Owner - Builder
My Commission Expires:
S5
mpliance with all applicable
Date
Date
BOND
TOTAL DUE
3 -(41 -97
APPROVED:
Zoning Building Electrical
Mechanical 6 1 1`) Plumbing Engineering