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126 NE 97 St (6)Disapproved (Signed) 0 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. � Date..._.._ : `Y Owner's Name and Address. .� �___ �° R No.. P-L Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done State work to be done and purpose of building (by New Building Remodeling To be constructed of Kind ofJoundatior Estimated Total cost of improvements $_. __ Amount of Permit $, Zone cubage required U -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 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 permit, as are licensed by Miami Shores Village. Remarks (Signed) {•" therein by him stated are true. Permit No. .... ` t ____ -_. Date MAA O S N O REM VO LLA E BUILDING INSPECTION DEPARTMENT APPUCAT0®ON [FOR 20..DOL®MS PERWIT Subdivision floors) �_.e/�.s�_�- - - -• -- and for no other purpose. Addition Repairs No. of Stories oof Covering 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 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 Chairman Member Member Council Approved Date Date - Notary Public, State of Florida NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice materials and /or workmanship. I • - 1 Street._ . . Read, Sworn to and Subscribed before me. Building Inspector My Commission Expires PLANNING BOARD DATE Member Member Member Disapproved Date has been obtained from for inspection or faulty Approintd .Correct Ion Re -Insr n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Request .D.ye Type Permit No. /40 / ( A Name SA) Addrm Company Phone Of inspection Date BUILDING PERMIT APPLICATION FBC 2001 Contractor's Company Name De r Contractor's Address L i „1 Total Fee Now Due (Continued on opposite side) Miami Shores Village Building Department 10050 l.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) `` I. • /1, . #Phone # Owner's Address - A (-= a . ' City State Zip Tenant/Lessee Name Job Address (where the work is being done) i - (' Ai e ' City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO S �) . 6 r ti� , I J 6 City State Zip Qualifier ✓ . ,r i State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # S Value of Work For this Permit 6, , � - ` Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑ Demolition /- f_ " J f! Describe Work: � %: e e_ f j'� L �` �ti G� � 1 /.>:.� j r ,v- ** *** * * * * *** * * * *** * * * * * ** * ** F ees * * * * *** * ** * * * * * * * * * * * * * * * * * * ** Submittal Fee $''; ., � e.y.� � Permit Fee $ . "= , � CCF $ � D CO /CC Notary $ Training/Education Fee $ f 0 Technology Fee $ S 0 Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ fc0F1 gP /5 Permit No. Master Permit No. s Phone # A Phone # � �' f C% - 2 r j Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) rr / f{ Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _, by , day of , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced Ac identification and who did take an oath. as identification and who did take an oath. NOTARY PUI Sign: Print: My Commissic * * * * * * * * * * ** * * * * * * * * * * ** APPLICATIO Chc 05/13/03 Plans Examiner J Engineer �. En eer :��',�� ! ' � tag Zoning / State ` Zip [NOTARY PUBLIC: Sign: Print: My Commission Expires: ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** • 10050 N.E. 2nd ►;venue • Miami Shores, Florida 33138 • 305-795-2204 Date Job Address / -' ✓ ' Tax Folio if - s Legal Description Historically Designated: Yes No Owner /Lessee/Tenet Master Permit # Owner's Address Contracting Co. Address t Qualifier / - SS# Phone State # Municipal # Competency # Square Ft. Estimated Cost (value) Signature of owner and/or Condo President Notary as to Owner and/or Cond My Commission Expires PERMIT APPLICATION FOR MIAMI SHORES VILLAGE "...'.1 ;Si J, Uo18,3411 • J a nr • ACv,�,� r;bat, Phone Date Signature of Contracto or Owner Build er/ Notary as to Contractor or Owner Builder Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: 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 ANY 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 all disciplines. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be ne in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work st ed. / My Commission Expires ° - R•� - °° y" Date Date FEES: PERMIT RADON C.C.F NOTARY APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing Structural Engineer NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION • � PERMIT NO. TAX FC�IO NO. 1/° .12-06°0/3.25549 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: M9 , 1/ J// S SC / Q/ P,7 72 1OT/l,)/ a-' 7 tai 9/ / Z7r // L L/ €/9 / .Z& ,w6. 97 .. /:.€4 4- --7--- /,M// . X'It5 FZ . 33/38 2. Description of improvement f (///f/vie /2 //T 3. Owner(s) name and address: ZAlil . rerkC.9i,/iit/ /26 c . 97 s7 Interest in property: agi Nc2 Name and address of fee simple titleholder. 4. Contractor's name and address: Seats 466 g' e°2. 5. Surety: (Payment bond required Name and address: Amount of bond $ 6. Lender's - name - and - address: Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8/02 by owner from contractor, if ItIME OF LO" 111 CC ''. I HEREBY C. ' FS' Al provided by Section 713.13(1)(a)7., Florida Statutes, different • ate is specified) Si • a e of Owner Print Owner's Name v t ZA 02 67l .1 , /7 Sworn to and subscribed before me this Q( day of A , G'5 2 - 2.0 -1 ices: 3 ?/S?3 Gi O/ &L SaAJ/ , sg &v/). /2,4w wnvN Fe- 333/3 c :FN 2004R071 730 OR Bk 22584 Ps 2806;flps) .RECORDED 08/18/2004 11 :19:46 HARVEY RUVII'h CLERK. OF COURT MIAMI -DADE COUNTY} FLORIDA LAST PAGE 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: y� fx 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a 6 N6 A) Prepared by / P5 PAUL ARIAS i •' egQN_#DD186411 EXPIRES: FEB 20, 2007 Bonded through Advantag 111111111111111111111111111111111111111111111 s: 935,A1.u/, 3/ fd�o�uE "4,5u Ire D. PoiuP/WW Sii�I� fL ?069 !Tam: Cho= VGC" 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/2/2004 Parcel # 1132060132540 Applicant: DOUGLAS Owner: MCLAUGHEN JOB ADDRESS: 126 NE Contractor SEARS ROEBUCK & CO Local Phone: 954 - 590 -2203 Signed: (INSPECTOR) W �' � � `►r►1��11 Ill W�I W �i �il � � � �� � � Ill Permit Number: MC2004 -114 MCLAUGHEN DOUGLAS 97 ST Fees: FEE2004 -6583 FEE2004 -6584 FEE2004 -6585 FEE2004 -6586 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $100.00 $4.20 $1.40 $2.50 $108.10 Total Fees: $108.10 Total Receipts: $0.00 Contractor's Address: 6801 w. sunrise blvd. Permit Status: APPROVED Permit Expiration: 12/27/2004 Construction Value: $6,504.00 Work: A/C REPLACEMENT 4 TONS Signed: (Contractor or Builder) Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 10 & W5FT LOT 9 & E1/2 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 I assume responisibility for all work done by either myself, my agent, servants or employes. BY: Page 1 of 1 • cK 20m11j Address MIAMI SHORES VILLAGE BUILDING DEPARTMENT A 305-795-2204 B ilding Inspection Requeste&Zea_ AaA' DatC j 60 r • / 142 Type Insp'n Permit No. Name Company _ ',- Phone # Inspection Date Approved IJ Correction ga, //2"e-- ;760'‘,/ Re-Insp'n Fee EJ / 1 - A47 ‘ 9 4 4 zAe__ C_422/e 9 it-) a C,C - MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 Building Inspection Request(,-;th,/,','' -f /— , , Type Insp'n !.- Permit No h 4 f I" Name Address ,7 / 70- Company Phone # :\ ) f , f /),,/ fo.. • Inspection Date Approved Correction Re-Insp'n Fee 2 /"" - z;11/ ;■,„ r // M1Al1I BUILpING Bi'lidin4 Date 1 /j1v Islip' n SHORES VILLAGE DEPARTMENT ':►5493- 2204 Inspcctic rL Re ? +-- SS :rmicNo. k II i 044' ! 14 szne .(,�,,. dress -7 �nn tC ? r\c 4 1 Z ampany 1 is L ‘' lone #i speedos Dave ppraved arrection :- Insp'n Fee � �� � . l !! Cli n p A F In A