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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 L - 1 3 - `3/ Job Address / b rJE • 9 S T Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant H '13 G ..z (o o Master Permit # Owner's Address / c P 1 C . c ” - ' . 77_• . Contracting Co. O\i /N E!:_ Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ?A. 124.-A-t. p 1/4 - 11 - 3T 4 - 1aP - W t 1 TC r� t" Square Ft. Estimated Cost (value) -44 5 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 pemnit 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: Pe il7ti-/ / 0 0 FEES: PERMIT ' O RADON APPROVED: Zoning Building Phone 3 °S' X — 4 - !' • of; j �i L. C. 5 - "A•7 "' OLfo A -rot. ?c./l -yT EIZ c � eyr Contracto or Owner - Builder Date otary as to Con My Commission Expires: f - f �J� Li& CO C.C.F. ?. NOTARY tor or Owner - Builder qq��SAAA TA EL 1• ` �RY-1 ria SOON NUMBER it 5 ; III. , Q CC797277 4� � MY COMMISSION EXPIRES OF FAO DEC. 17,2002 Electrical c rJ F. Loot& 4- ter;nr Date BOND TOTAL DUE Mechanical Plumbing Structural Engineer PERMIT APPLICATION FOR MIAMI SHORES V,LAGE Date 1 � Job Address 4. //G1 9 7 5 77 Tax Folio Legal Description / Historically Designated: Yes No Own / Tenant A bb( e_ / \ 5Q / F Master Permit # 3 '' / sap ) Owner's Address PO K S 3 e °j S s /' GLVcti Sit O'r PS F2--- Phone k ? Z .9' Z k 2 (e,e- Contracting Co. n ! Address Qualifier S Phone State # Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Gt i`/+l f e K T pfr"? Square Ft. Estimated Cost (value) ( O �} 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. 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. Signature of owner and/or Condo President Date 1 Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT L RADON C.C.F. NOTARY 1 TOTAL DUE "I ,' APPROVED: Zoning Building ` Electrical Mechanical Plumbing Engineering `use min_ 02-1° f r -r. Signature of Contractor or Owner- Builder Date Notary as to Contractor or Owner - Builder Date My Commission Expires: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE • Date 09ob Address l/ -CI Tax Folio fi / .”& Legal Description /o ° / 7/29,4.C)/ 4 Q D /JL 02-artiZfri CS CA,). 74 K: if p At 2 J - t3 L i19 , lAv 9 '''- 72f z Z Owner's Address Phone Owner / Lessee / Tenant Master Permit # "a1,0"/ Contracting Co. Qualifier ,/,//1/bcd State tfk Municipal # Architect /Engineer Bonding Company Mortgagor Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / A)r E rrv °i' Square Ft. Estimated Cost(value) jC%` 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in comp ia#ce with all applicable laws regulating construction and zoning. Furthermore, I autho e the a ov : named contra or • do the work stated. C y t P esideatStateofftorda :My Commission Exp. April 30, 1 •':;��- ,a' . No. CC197545 Signa Date: t a n s to Owner andOmnyPoardomPriesaxde ot,ry Public: y Commission Expires P ersonally known []OR Produced I.D Type anJ number of I.D. produced: APPROVED: Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: ** * * * [ij DID takc oath or * * * * * * * * * ** . f� �j 0 DID NOT take an oath. L 0 /© /f FEES: PERMIT.57/ " RADON C.C.F. . •5 s7 NOTARY TOTAL DUE /� e Fire Other Zoning Buildin ( Electrical Mechanical Plumbing_ Engineering BUILDING INSPECTION DEPARTMENT /7 J APPLICATION FOR BUILDING PERMIT id // Application is hereby made for the approval of the detailed statement ur rule plans and specifications herewith submitted for the build ine 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 Villmc 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 ..!/.: Registered Architect and /or Engineer ,,, „,,.r,,,.. 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 State wofk to be done and purpose of building (by floors) (.rt.�..%d't!_ r te. _,� .�yi_ . 4 .. . -, �/ -� _.._ and for no other purpose. New Bui!d Remodeling Addition epairi V No. of Stories ,l _ Building Inspector (1 3 6 d_3 MIAMI SHORES VILLAGE r() G 19 �J -- N o._. f�! ...._....... Stree 2 _ ...„71.*14 Art^ - Notary Public, State of Florida My Commission Expires To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $•,//Q..Q - .47.-t,) Amount of Permit $. .... �„- �- . .. 45 .. c OQ_ 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 ‘Vorkrnen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied ssith 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 or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. Remarks ( Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorizcd to administer oaths and take acknowledgments, personally ap- peared to me well known, 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.._..j.4 L U 5 Dat //3 .._._._ Read, Sworn to and Subscribed before me. Disapproved -. Date.._.. (Signed) PLANNING BOARD DATE Chairman Mcmbcr 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 been obtained from the I'I.in nir.g Board. A rc- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 2I)