325 NE 96 St2-
Permit
Owner's Name and Address
Service Overhead Size Feeders Conduit
Underground
Amount of Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work.
No.__ Z .5" /4 E _—. Street__
Registered Architect and /or Engineer
Employing Electrician's Name — it.L + /4-77 No
Location and Legal Description Lot____________— ___ - -__.— ________________Block __
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling —____ Addition.. Repairs _____________ No. of Stories
Main Sw._______- -_____ Amps. —____ Main Fuses_________________Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
""'" •ftrA7 ��'
(Signed)
(Signed)
Date
Street
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eneral Laws of Florida Permanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
er
Master Electrican.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is t h e _
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.
' My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO.LAM PS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
• NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
2-
Permit
Owner's Name and Address
Service Overhead Size Feeders Conduit
Underground
Amount of Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work.
No.__ Z .5" /4 E _—. Street__
Registered Architect and /or Engineer
Employing Electrician's Name — it.L + /4-77 No
Location and Legal Description Lot____________— ___ - -__.— ________________Block __
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling —____ Addition.. Repairs _____________ No. of Stories
Main Sw._______- -_____ Amps. —____ Main Fuses_________________Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
""'" •ftrA7 ��'
(Signed)
(Signed)
Date
Street
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eneral Laws of Florida Permanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
er
Master Electrican.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is t h e _
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.
' My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
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.
Owner's Name and Address ._...,l N S R D , 6d ev/t-2 p
Registered Architect and /or Engineer n
Name and address of licensed contractor y A-1 £ Oq t o ed A
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)
Disapproved
(Signed)
Date
Building Inspec
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Council Approved Date
iG St
Date
No Street
j•- (o•I0c
Date — SG_ Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Chairman
Member
Member
,19C1
ALE-96 Sf-
1 SI-1> 2 IZ -SI p aJGE.
t 0u)'J i 13G' T4 P5, w__! aP ac s
and for no other purpose.
New Building Remodeling ✓ Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Q 02- you
Estimated Total cost of improvements $ f 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 rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint
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 work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
Volt e_0 �7 ( �NL
CJCtic._- D � •
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
therein by him state d are true..
Permit No 6 `
(0 k_
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
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.
4
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10/18/2004
Applicant: ANNE
Owner: MCCOY
JOB ADDRESS: 325
Contractor
Local Phone:
Parcel # 1132060135890
MCCOY
ANNE
NE 96 ST
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2002 -1541
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16
Fees:
FEE2002 -4950
FEE2002 -4951
FEE2002 -4952
FEE2002 -4953
FEE2004 -10183
Description
Building Permit Application Fee
Buildier's Bond
CCF
Notary Fee
Renewal /Extension Fee
Total Fees:
Amount
$60.00
$300.00
$1.80
$5.00
$60.00
$426.80
Total Fees: $426.80
Total Receipts: $366.80
Permit Status: APPROVED Permit Expiration: 4/16/2005 Construction Value: $2,500.00
Work: 5' X3'; CARPORT WALL /SHUTTERS - RENEWAL ON 10/15/2004
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
BLK 43 LOT SIZE
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2002 -1541
Printed: 9/24/2002
Applicant: ANNE
Owner: MCCOY
JOB ADDRESS: 325 NE 96
Contractor
Local Phone:
Parcel # 1132060135890
Permit Status: Approved Permit Expiration: 3/2/2003
Work: 5' X3'; CARPORT WALL /SHUTTERS
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the t
ordinances pertaining thereto and with the understanding that the work will be perfo
and approved by the proper municipal authorities. This Permit may be revoked at a
authorization. A further condition upon which this permit is granted is the understan
ordinances and regulations pertaining to the work covered hereby whether shown of
by his agents, servants or employees.
Signed:
In consideration of the issuance to me of this permit, I agree to perform the work c
ith the plans, drawings, statements or specifications submitted to the proper author
elf, my agent, servan . or empl• s.
Signed:
(INSPECTOR)
Building Permit
(Contractor or B
MCCOY
ANNE
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 15 & 16
Fees:
FEE2002 -4950
FEE2002 -4951
FEE2002 -4952
FEE2002 -4953
Description
Building Permit Application Fee
Buildier's Bond
CCF
Notary Fee
Total Fees:
Amount
$60.00
$300.00
$1.80
$5.00
$366.80
Total Fees: $366.80
Total Receipts: $0.00
Construction Value: $2,500.00
'.. j95-751-1.210 •
C4(87 t
ay to the.
YF Order
1.
HationsBan
— NationeBank, N.A. -"
... ACH FVr 083000047
For
Page 1 of 1
_,Newport
s:06 300004 ?I: 00 1 196 29996 Se
Date
BLK 43 LOT SIZE
1990
63 -4/630 FL
1348
= Dollars= -
0
•uscnrc,l TREASINES TV,
PROPERTY OWNER
New Construction
N am • y J i.. 4
11 .
Addr -Til
--- 3,s /“"
_
9 (,, ,,
%,„
Home Telephone 1 _ �1
d �
Alteration Interior
Business Telephone
Demolish
Fax
Relocation of Structure
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address:
Folio Number
Proposed Use of Property
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
325 oz sikvr
Address Apt.
Lot t) j 1 Block 43
Subdivision PB PG
Current Use of Property
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No. _
Subsidiary Permit No.
City
Zoning
Square Feet
Value of Work
Units
o
State
PERMIT APPLICATION
Floors
Linear Feet
33136
Zip
Bldg Value
Tenant Information' Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
Print Name
of Owne
S to and subscribed before me thi
ture of N
CCU 37(
STATE
Signatur
SEAL:
I' • I
..4. •_ L
,rr Public .
tate of
rida
MIAMI -DADE
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
PERMIT APPLICATION
♦P �Y p OFFICIAL NOTARY
ANGELA M BECXES3 SEAL:
2 ,� �, �O CO/MASSor u23ER
" '9i'•`� Q CC786697
s CO MY COMMISSION EXPIRES
OF FAO NOV. 15,200
Personally known - OR,ProeltteetttdeTiBfrcation [/ Personally known OR, Produced Identification
Type of Identification Produced: F.&i))-. IV> y y D-43-yS,9ype of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPN.
Dryer
QTY.
TYrE
Outlet, Appliance
Q 1 \.
' I - 1"11:
Service Repair
(I'Y.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE QTY.
Minimum Fee
TYPE
Condensate Drain
QTY. TYI'E
Generator
QTY. TYPI•. QTY.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
- Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE:
A/C Condensate
QTY.
.LITE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTV
TYI'I?
Soakage Pit
QTY
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet .
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D
Zoning
4
a - ' .1-
Electrical
Mechanical
Plumbing
Fire
Public Works
01.
9(
Structural
}§Z
Building Official
/��
v
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
$
$ n AD
$350.07)
$ [ ( sq.ft. = x/1000
x ¢.60)
$
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
O IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL
Z 6,8 o
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PERMIT NO.
ADDRESS: •
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT .
SECTION
BY
DATE
ZONING •
•
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
' PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliancy with aft Federal. State.
Cocxtity.Village rules and regulations. Wage
no responsibility from
sibility for accvrdcy oUor results fro
or =
2. This copy of plans must be mktg. on
budding slte or no Inspection will be conducted.
3'° N• �". �� sj
CRITIQUE SHEET
JOB ADDRESS
APPLICANT
PHONE # C�l�
APPUCATION
SHEET OF
MISCELLANEOUS
•
DATE
� CCOy
B UM ' COMMENTS
C, v,v A cot) gr 54L 4/R/6 79e 6
alx f . - i jQ coh.sriettrr
INITIALS
JOB ADDRESS
APPLICANT /I r Coy
PHONE #
APPUCATION
SHEET OF
MISCELLANEOUS
DATE
ZUJVI.Ny
CRITIQUE SHEET
COMMENTS
. P I e tc r FE 6.14.
:C-a' I ek o walzr V G/ a. k /od-
PERMIT NO.
ADDRESS:
SECTION
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
BY
STRUCTURAL
BUILDING OFFICIAL
2. This copy of plans must bo
bu1ding site or no Inspection will b
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT•
DATE
1. Subject to compliance with aft Federal. State.
Cocztity, Vdtage lutes sod regulations. Yiltage assumes
no respo s for accuracy otlor resutts from
�
LJ+ E to J"e /7'Tt73 ;y
et A -5o NgI C iD/w5T.2 L 7'b& G4 '
kit e - S PeerFlc/kcy t Fl- ty'T=V
t Jo o) F 7tJces°
available on
a conducted.
INITIALS
STATE OF FLORIDA)
COUNTY OF DADE)
performed on
The undersigned Affiant,
attached survey, performed by
Witness(sign and print)
RY P OFFICIAL NOTARY SEAL
1P' U d < ANGELA M BECKER
2 -vNtif i 0 . COMMISSION NUMBER
a . 'III' -+4�. ¢ CC786697
7 1' cg MY COMMISSION EXPIRES
F OF F.O NOV. 15,2002
AFFIDAVIT
(name of surveyor's company)
does hereby attest that the
00 `,is an accurate representation of the existing conditions and
(• . to of s vey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this day of
Affiant is personally known to me roduced F1 --1)L, 1O0 - 40-6? as identification.
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Home page for Kestrel DIY Shutters, Shutter Hardware & Folding Screens.
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Since 1989, Kestrel has been a global provider of the finest quality
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7/11/02 10:42 AM
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Kestrel Exterior Cedar Shutters - custom and standard sized true pegged, mortise and tenon wood shutters. 7/11/02 10:40 AM
•
Exterior Cedar Shutters
Kestrel Exterior Cedar Shutters -
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