797 NE 94 St (11)Owner's Name and Address .....
Location and legal description of lot to be built on:
Lot Mock Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by (loors)
MDAM11 SHORES VOLLASE
BUILDING INSPECTION DEPARTMENT.
APPLIZATOON FO
lot
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 conforrnity 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 budding during progress of the work.
E.%
UllLENNG PERMOT
Registered Architect and/or Engineer
Name and address of licensed contrActor / 0 c M CAD 5
. •!t1,11.. !TV, 21,21
i
and for no other purpose.
Repairs No. of Stories"
?A v et Aar
fiLr-cets
New Building Remodeling Addition
To be constructed of Kind of foundation oci Roof Covering.
Estimated Total cost of improvements $ Amount of Permit S.
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
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 bc performed under this permit; and will post or cause to be pox d for inspection on the 'te of the wor Ch ublic notice
or notices as are required by the Act. The undersigned agrees to employ only su subcontractors, on w rk to be form •er- this
permit, as are licensed by Miami Shores Village.
Remarks
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
•--- ...... -^•______
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 tru
Permit No._ / Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector
(Signed) C206,6e=
to me well known,
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from
the Planning Board.
A re fee of 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
PERMIT APPLICATI ON FOR MIAMI SHORES VILLAGE
Dat� 0
94 Job Address / ( IVI 2 Tax Folio
State #
Legal Description
Contracting Co. L ,A--A .1 is
Qualifier , L', ' 2 3"-/ �✓ tf ,
mac -9 x
4/4
Mortgagor /01
Architect/Engineer
Bonding Company
Square Ft
2 k& t ,14 G
I
Signature of owner and/or Condo President
My Commission Expires: G J
Owner/Lessee / Tenant " 'd 44 444,57/2/ Master Permit #
Owner's Address 7 c 7 ��LT 9' f��6 /' e , 11;QG'4 Phone 7 r 7 Z 769
Permit Type (circle one): BUILDI ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 4.0 �/ 441"C.0 01/rSi
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOU 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 co i tractor to do the work stated.
f r
'Notary as o Owner and/or Condo Pry dent Date
OFFICIAL NOTARY SEAL
GEO?CE A FRIX jR
NO'T'ARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC201557
MY COMMISSION EX . MAY 14,1996
FEES: PERMIT 5 / i &ADON C.C.F.
Municipal # Competency # Ins. Co. /4' 6
Historically Designated: Yes No X
Address
SS# 7r 9 -
Address
Address
Address
'- -Z�R mf
Estimated Cost (value) DV 0
, J
ctor or
ignature of Con
7 '
7 777
4 1- fl 0J Phone 7 7` 6 7.5":5 ;
wner- Builder Date
Lac- .A. 1, 314r/rc--
lotary as to Contractor or Date
My Commission Expires: f
Z, A
k--4 W r® f ®%1a4' .
OFFICIAL NOTARY SEAL
GEORGE A PRIX jR
. ;:. f_ 'T i. OP FLORIDA.
COi.,b• 10tv,d- CC. . 557
raw C::'': " -;ON :(1). 104, y.., r„
NOTARY TOTAL DUE
APPROVED: j X11
Zoning Building Electrical
Mechanical Plumbing Engineering