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1249 NE 97 St (3)t . 4 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Job Address /2 / 9 7 577 Tax Folio Date Legal Description Master Permit # #. rzm' Owner / Lessee / Tenant Q # 411 / 2 6 - Ae - -9"7 Owner's Address /2 Contracting Co. P4" 9t 4 Qualifier /' C' State# 40"/670 - Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING(iEC )PAVING FENCE WORK DESCRIPTION / X7 ' di 1 /- 77/cif 67A1 j f��l it'd / _4 /% /9%0 pd Z 25 , �® , � Zs /��.cs'S ZeRie. 4' cG b4/1FL/'J6, Estimated Costj Square Ft. 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. L. Sig • t ye of Owner a,4/ r-ode - ride t Da e: Not at to Owner and /or do President My ommission Expires: 440 qq PERMIT FEE: APPROVED: * apical "\ P 9 Phone 75 9 aleg g 9 514172 eV 7 41 lkw it5 Phone ‘4 C�C'O �(o b , �r P_ A. ;''UC /Ars: c o Competency �� Ins. Co /M c. A00. C / /)¢G 7K4. Fire Address Address Address Address Sizft.jre of Contractor or Owner- Builder to: /i2 / .9/ i LO Notary a to Contractor o er- Builder My Commission Expires: ;OT.RV pU "_ c Sii':f k- . * Other • * * * RAY C0 IY::*SiC;; *' al!DED F ,ci 5 SIGN Building Electrical I bing Engineering O CO co 0) 0 m tf in m co fh 07 02 co Q co J E 8 .. t0 o C co "43 cn cii C Q g. AMU � 1 . co q - OX,VH g,QOO i 2 1249 i �r7 1 a,,awoaac J FC0iii LA 'J ,Jew cooDE+UUIJb (hi IT ' 2 LO6AK 2 C—�` 1DEIJCt (24, KY5 ci sr S. 0\451214406 0 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 7718 DATE Contractor's License No. Work to be performed under this Permit B1 BY AUTHORITY Subdi- vision Address of Value of I Amount of ;x Building Project $ I Permit $ 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 applica- tion 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 or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. y . 7 7 .rte Signed. ! � ( i, INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with ail trdinances aid regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao cepting this permit I assume responsibility for all done by either, myself, my agent, servant or employee. / I r Owner's Name and Address PIA L Li P C A tvk NAT t Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot_______— Block MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 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 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 progress of the work. A E v c j ----- C o ` 2 ¢ lm^ ®( c ta; (L -c C(2 G-+. Subdivision Date Street and Number where work is to be done kl _l A��. _ R. ( rt. t T - Pk) ,19 Street t. ) .b State work to be done and purpose of building (by floors) s.) C. 1) 0 C-t 0 R IC °-r o C o Q e and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation_ Roof Covering Estimated Total cost of improvements $ 1__( O O ' Amount of Permit $ 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 toi U SI A L L A T ( O 0 D __ T < E l _ Q S � `t ow C o z 1 4.) 1/4.4.: C®°i .* 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 5986, 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 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 subcontractors- on w rk to Ile performed under this p Village. o Remarks_________ nmtas are licensed by Miami Shores Villa a (Signed). E ��` b'n ) y STATE OF FLORIDA, COUNTY OF DADE. j ss • Before me, the undersigned authority, a notary public, duly authorized 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 tru 7.1 Permit No 77—/ c. Date 7 — � Read, Sworn to and Subscribed before me. Disapproved (Signed) Notary Public, State of Florida ilding Ins . ector 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 been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improve: n Iti�•e for inspection or faulty materials and /or workmanship.