970 NE 94 St (6)Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date w `
Type lnsp'n i- � L t
Permit No. e o+3Cj3 - I O
Address G �\ ^ ( 94,s4-
Company 1 )V 1
Phone # 034' e (ikJ
Inspection Date Sl{ 14 S4- D
�
Approveg 2 L t — � z. (2,0
Correction l ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reques
Date
Type Insp'n ooLL 2 ��77
Permit No. KC., 200,3- 1�lv .
Name bSsmcci-
Address 1V IvE q4 51
Compan (LkocJcIe uood?
Phone # GU`i b`1 q(0
Inspection Date aJ )-y
Approved .>.7i 2I2 ?..o
Correction ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE {' f 1 / 195
PLUMBING o PERMI 8865
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
Bl.
CONTRACTOR OR BUILDER
Contractor's
License No
Work to be performed under this Permit ` ' ` 4
si
Subdi-
vision
Sq. Ft
Value of
Project $
Signed • BY
INSPECTOR
Amt. of
Permit
r
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements pr specifications and that he assumes responsibility for work
done by his agents, servants or employees.
i
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit .l assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Date
PERMIT APPLICATION FOR MIAMI SHORES VI
Job Address 6 110 NE �'+ sbfi1 Tax Folio 11
c_Lip K��,
S � ��tvlSv� � 51 — S Historically Designated: Yes .... No
er Permit # E X Z
Legal Description — \
Owner/Lessee / Tenant • —ti�G.� OS S t)--t f
li
� �� � 4°4" rf7 3 1� Phone - 0 — {�� ° O 1 �, Address / 2Sj I f((0.liY'I(CF.e 1 (440 - Phone qt�j s�'f -qt ze., .
Owner's Address cl'-1 �j 3 �
Contracting Co.
Qualifier C— K 07 t‘7V
State # �Q (! O fl Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
CANDYCE B. TOLEMAN
YC ISSION# DD211485
FEES: PERMIT t ✓ RADON
APPROVED:
Zoning
Mechanical
C.C.F.
NOTARY
Permit Type (circle one): BUILDING ELECTRICAL PLUMBINgECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �ifS7 1— �5 = l Oki Spirt S / 7 o / `'` f /0 / )
Square Ft. Estimated Cost (value) 41, ! $ � , () 0
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDL3
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 regulatins
construction and zoning. Furthermore, I authorize the above -named contractor to do the worksta>
L -- - C '
lignatur of Contractor or Owner- Builder
o x% r or
'olY , ,. • CANDYCE B. TOLEMAN
MY COMMISSION # DD 211485
I'oF noa EXPIRES: May 12, 2007
1-8003- NOTARY FL Notary Discount Assoc
.
•
as t 0 ommi
V >1/0:3
Date
26 PAID
BOND C is i 1 F t
TOTAL DUE
Building Electrical 6 to v l C I53
J51 � Z4/'.c3 Plumbing Structural Engineer