261 NE 97 St (10)Date_
Legal Description •
•
Or
Owner / Lessee / Tenant -12-)e..._ C ' (-�(3 `6 %)� SMaster Permit #56,e ---
Owner's Address 9 C l Phone /----) __ ■ rl 3.
Contracting Co. S Q \ /CW/ Address S O NV
Qualifier - Phone eN,A),-.• Q
State 1i Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one : BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
\ rl / r_
WORK DESCRIPTION \■ 0, :kNAN
Square Ft. Estimated Cost(value) C) C
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 DAVIT: I certify that all the foregoing information is accurate and that all work will
be don in- compliance with all applicable laws regulating construction and zoning. Furthermore, I
auth i e e abov -namesi1oitractor to do the work stated.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
�• Job Address � J 3 Vim' "-- �� • Tax Folio
Signature of owner aftd /or Condo President
Date: ‘r2 Icy
Notary as to Owner a
My Commission Expire
Date:
Signature of Contractor or Owner- Builder
Notary as to Contractor or Owner-Builder
My Commission Expires:
FnC @ Rhr SEAL
.. T % SCOTT W DAVIS
Jai . COMMISSION NUMBER
' 0 CC255237
1 7 . F ' �Q MY COMMISSION EXP.
** * * * 1_* 9F \°. .L 7. 2e4997 * * * * * * * **
FEES: PERMIT RADON C.C.F.
APPROVED: Fire Other
Zoning Buildin_� Electrical
Mechanical Plumbing Engineering
NOTARY TOTAL DUE 144$47
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.
�° Date I :';
�
� r
Owner's Name and Add �. _ ' O v'` 2
�� � - - -i—� � ' No.- --� �� Street._ �,/ 9
Registered Architect and /or Engineer
Name and address of licensed contractor..__ �'
STATE OF FLORIDA, f
COUNTY OF DADE. ss.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) _
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 $ 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 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 inspec ion n the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcony' ct rs, onn ,wofk to be Performed under this
permit, as are licensed by Miami Shores Village.
Remarks
(Signed):
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 e //
Permit No e, C) are
Date Z i Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
z._ Date__.' _� ^
B Idin Inspector
ector P
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan 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 improper notice for inspection or faulty
materials and /or workmanship.
• • •
1 4.
Pr
-27
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date .1 - /// - Y C Job Address / / a /L,. /O / Tax Folio
Legal Description 4 0 7 . 7 +- 1 :4 - 5 T W 4- rip t' Historically Designated: Yes No
, , 3 , / ) D q / - e ri , 3 Ao -0-S ,� �
Owner/Lessee essee / Tenant Doi oft €3 H Go € S - S reJi Master Permit #
Owner's Address / .. / o 4 £ t® o T ✓f ,. ‘ 5 4 .o , �..s Phone (3 OS `75 7 ^ 1 4 7
Contracting Co. o o w vi wIP --, Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer
Bonding Company
Mortgagor
Signature of owner and/or Condo President Date
FEES: PERMIT 1-- RADON
Address
Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MEC CAL ROOFING PAVING FENCE SIGN
Of �t� eae eaG e +- rJ
s
.
WORK DESCRIPTION i. � -- _ ,' - - =-= m / /�r 7( �t 7 9 �-°� `- - -
. 5 l.r, tA/r -e - e 4-4-g l /40 � --
0 -e vt /y /.41 To
3 5,.9 - e
Square Ft. Estimated Cost (value) 5j �� - e'
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.
e
Notary as to Owner and/or Condo President Date Notary as to Contrac or or Owner - Builder
My Commission Expires: My Commis ' E ires:
� - �FVttXlttL NED'f tiY
0
F 0 / O P Ue SS MARO` NEIL
O d l oc� f,, `3 �
Q CC797277
-7f o
Q.. MY COMMIS^,a1 EXPIRES
OF f�O DEC. 47
C.C.F. / NOTARY ' .
, BOND
TOTAL DUE VS o
APPROVED:
Zoning
Buildin
Electrical
Date
Date
1 /y'%
(D
Mechanical Plumbing Engineering