1075 NE 96 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date S /31b b c Job Address 11)7,$ /' , E . e J Ll ;.$ T Tax Folio
Legal Description Historically Designated: Yes No X
O w n e r / L e s s e e / Tenant m r 3 . L t o I I 5 14 Lt rJ Master Permit #
Owner's Address 1 l> "7 S /\J r. 91n - S I Phone 3 r)f , 75 .5 6 i
Contracting Co.
� ig 1- }i31 )U. w. ) 7 5 " c— r- Q " 3 "— e) N u W r,I;.R � o � Address
Qualifier 'Tptt a 'WE. rL SS# Phone 3 07 - 4,2 9 - 177 a
State # Municipal #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOF t ! PAVING FENCE SIGN
WORK DESCRIPTION ' RI. e A tr-
i
FEES: PERMIT
Notary as to Owner and/or Condo President Date
My Commission Expires:
RADON
Competency # / 19 W Ins. Co. �s,1, t �« o
roe, iEAk t0.) — r,
C.C.F. ` 60 NOTARY
733
Estimated Cost (value)
"�s
Square Ft. 3 ./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.
OWNERS 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.
f 5/3/C O a
Date Signature of . ' : ctor or Owner - Builder Date
Notary :.: o gpitt act 4ۥ 1 JAR.
My Commissipn ExpiresCLAQ'ff, , 3 V'1 LAI
M AT..f T JE e3C STASE P i.O ICA
COMMISS!ON NO. CC/1/2103
!' MY CONviMEscON,W_. 0
J '
BOND
APPROVED: TOTAL DUE
Zoning Building f / " Electrical
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed statcss.t•nt or the plans and specifications herewith submitted for the build-
ing 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 Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during prpgress of the work.
Owner's Name and Address Mr. Frank Lougl'a1?l • - _
Registered Architect and /or Engineer , ,,,. „,..., „•,, „,.., „,...,,.
Name and address of licensed contractor Obenour Roofing Co. 7357 N. W. Miami Ct Miami, FL 3315;
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1075 N. E. 96th Street
State work to be done and purpose of building (by floors) Remove existing roofilS and replace with 1” white shingle tile --
New Building Remodeling Addition
To be constructed of land of foundation
Estimate Total cost of improvements $8,740.00
Zone cubage required
Distance .to next nearest building
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 nd its construction may
be sent to.. Obenour Roofing Sheet Metal & Supply Co. 7357 N. W. Miami Ct.
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 .sith 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 are required by the Act. The undersigned agrees to employ only such subcontr actors, on work tgbe irformed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. j ss-
Before me, the undersi d authorit a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared O.McLS nt'
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 carefull read the foregoing ' application , and hat did sign the wane, and that ell facts
therein by him are true.. �j
-l?! (, 1 Date ,��`� Rea rn t
Permit No
Disapproved
(Signed)
Building Inspector
PLANNING BOARD
January 28, 85
_ No.1 _.. Street N 96th Street
__..._........ for no other purpose.
Repairs Reroof No. of Stories _
Roof Covering
Amount of Permit $.20.00
plan Cubage
Size of Building Lot
Chairman Member
Member Member
Member .. .. _•..•._......_..._._ ..•._•.•.... Member
Council Approved Date Disapproved
o and ubsc . .
r
P
t, i 0
before mc.
Notary Public, State of Florida
My Commission Expires tla?ar?.2-ubtik .Sta12.131-1ati a4.lj ..
My Commission En,rsras Sept. 2. I 3
DATE BCNDt O THRU HUCKLEBERRY, SIELEY
a HARVEY Inlsu^t. :ace a BONDS, INC.
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 1'lannir.g Board.
A re•iu.pt•c•tion 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.