361 NE 97 St (6)Date Job Address 41 IQ E g1 Sr, Tax Folio 1 1 - 32 mh -- c 13 — E.::. } (o O
F3LK 4
Legal Description LOT 194 20 6EG I Am B FB) Historically Designated: Yes )4 No
Owner/Lessee / Tenant IAN 13 I NG E1a / VGN1 rM i Tl4 Master Permit # 1 gr
Owner's Address 3 t NE 91-1' 9T • Phone T66-2(006
Contracting Co. SELF Address
Qualifier SS# - Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING -ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION A I N I )f ucTV iE AK; 112.I M
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 ME CAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work wi be done in compliance with all applicable
ated.
la uwiu
• • structio i any oning. Furthermore, I authorize the above - . - • • • I actor to do the
te•► •.,o-h.r o
i a� ature ofmangy ;�jA : 43
- I NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC612715
MY COMMISSION EXP. J.N. 22,2001 _
Notary as to Owner and/or Condo
My Commission Expire ;
FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/ 29 98
ate
RADON C.C.F.
Estimated Cost (value) ex 0
OMMISSION NC). r Of)4OA
Y '• MIS . ION N. 22 2001
zgl
ate
_
La y ,:,J141111
Signa " , 4 . •
L
Notary as to Contr for or Owner -Buil r
My Commission Expires:
NOTARY BOND
Date
92
&-;e:
TOTAL DUE %L�_
APPROVED:
F
Zoning Building t / f Electrical
Mechanical Plumbing Engineering
MIAMI SHORES VILLAGE HISTORIC PRESERVATION BOARD
APPLICATION FOR A
CERTIFICATE OF APPROPRIATENESS
NAME OF PROPERTY (if applicable) :
ADDRESS OF PROPERTY:
NAME(S) OF APPLICANT(S):
(NOTE: IF THE APPLICANT IS A PERSON
OTHER THAN THE OWNER(S) , EVIDENCE
OF THAT PERSON'S AUTHORITY AS AGENT
MUST BE ATTACHED TO THE APPLICATION.)
ADDRESS OF APPLICANT(S):
(if different than address of property)
PRESENT USE OF PROPERTY:
FORM : MSIIPH.COA (adopted 4/95)
PAGE 1 OF 3
please type or print clearly
T)L- AcK.I.(.7 ELL F o U6E
NE ol 3 - r=
TELEPHONE OF APPLICANT(S): (305) 5g 2— g g ; (305) - 1 5 g " Z 3G4t
CLASSIFICATION OF WORK FOR WHICH CERTIFICATE IS DESIRED:
(circle the letter next to the appropriate classification)
MAINTENANCE OR REPAIR: The act or process of applying measures to sustain the existing form, integrity and
material of a building or structure and the existing form or vegetative cover of a site. It may include initial stabilization work,
where necessary, as well as on -going maintenance and repair. Samples of material must be submitted with the Application.
B. RESTORATION: The process of accurately recovering the form and details of a property and its setting as it appeared at
a particular period of time by means of the removal of later work or by the replacement of missing earlier work. All
applications for restoration shall include site plans (if required by the Building Permit), a statement with bibliography
historically justifying the work, and any additional photos or information to support the proposed work.
C. REHABILITATION: The process of returning a property to a state of utility through repair or alteration which makes
possible an efficient contemporary use while preserving those portions or features of the property which are sig:tficant to its
historical, architectural and cultural values. All applications for rehabilitation shall include: site plans (if required by Building
Permit), and any other supplementary information, such as drawings, that will support the proposed project.
D. DEMOLITION: The process of destroying or tearing down a building or structure or a part thereof, or the process of
removing or destroying an archeological site or a part thereof. The applicant shall include a report explaining why the proposed
action should occur. If this action is to occur for reasons of financial hardship, all pertinent fmancial data should be included
pertaining to the cost of preservation, demolition and new construction. Any other material pertinent to the application is also
encouraged as supplementary information.
E. NEW CONSTRUCTION: The process of constructing a building or stricture that has never existed at that location.
Applications shall include : a site plan, elevations, floor plan and/or landscape plan.
DESCRIPTION OF' THE PROPOSED PROJECT (Explain what changes will be made
and how they will be accomplished - use continuation sheet if necessary - all applications
shall be accompanied by at least one 3" x 5" photograph of the property):
pea NAtSSt0L.) ID P4I ti i
SIGNATURE OF APPLICANT(
SIGNATURE OF OWNER(S):
3. DENIED
SIGNATURE OF CHAIRMAN:
FORM : MSIIPB.COA (adopted 4/95)
PAGE 2 OF 3
CERTIFICATION
I (WE) CERTIFY TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF THAT Al
THIS APPLICATION AND ITS ATTACHMENTS IS TRUE AND CORRECT:
FOR BOARD USE ONLY
APPLICATION DATE (date application received by Secretary of the Board):
DECISION OF THE BOARD (circle the appropriate number):
DPPROVED y r 3 q tA,Ic:��� S
PO — l t -frr
2. APPROVED WITH CONDITIONS (set forth conditions b
PO -109
DATE: 72t/ii
fATF•
PH -53
DATE:
14472 Peach Chiffon
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION
FEIT FEE: APPROVED:
UNICIPALITIES OF DADE COUNTY
0 RETAIN COPY)
Contracting Co. (i /Gri l Address
Qualifier SS# - - Phone
State# Competency# Ins.Co.
Address
Address
Address
Fire Other
7o- Zoning Building '5 " t ri `j Electrical
S 00 Mechanical Plumbing Engineering
Z - - 0 /
Tax Folio ft 1f� oFfe,
Master Permit # ,14607.-5
Phone
BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
Square Ft. Estimated Cost - W 'G'
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.
Furthernre, I authorize the above -named contractor to do the work stated.
Signat of ggy1 ner andifftRITIACTXTMIPMA Signature of Contractor or Owner - Builder
Da : �' Y/ / MY COMMISSION F;t ?il;FS 5/09/91 Date :
/
t
(�( •0 � � tt!rtt St%mblc:- ,1duf".S
rotary as to Owner and /or Condo President Notary as to Contractor or Owner- Builder
y Commission Expires: My Commission Expires: