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639 NE 97 St (2)Name and address of licensed contractor. -_ Location and legal description of lot to be built on: Lot Block Subdivision MIAMI SHORES VILLAGE 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. rr �1 , � - . Date !,_L.t .2+. .E _ 19S Owner's Name and Address.. •j... tt,d-- s.. ..,. d` No.4 Street ' E ¶i -.41. Registered Architect and /or Engineer State work to be done and purpose of building (by floors) ..! 4 _i _trf 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 $ e5=0, 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 sunilar 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 sucp— bcontra tors, on wok to be performed under this Remarks (Signed) permit, as are licensed by Miami Shores Village. ( J I : Street and Number where work is to be done 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 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 true. Permit No L2` �_ Cl Date Disapproved _ tt ate,. (Signed) B ng Inspector BUILDING INSPECTION DEPARTMENT - 1,41, 2- a- X1 Notary Public, State of Florida to me well known, Read, Sworn to and Subscribed before me. 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 improper notice for inspection or faulty materials and /or workmanship. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 4 1 - 10 Job Address ( N 3 cn S 'trt et Tax Folio // 320,6 /7 /fI Legal Description - G ®7 =f,7 /6 44/7/ , .�� ..fee Lessee / Tenant . 0..., c), k, S .1 c0 \ V C,4 e..S \D %. r r f Master Permit # Owner's Address (0 1 °\ VJ '� ° T1 b - 's Phone -1 S(o ° \ OOto Contracting Co. - Owe e..r Address (0 3°\ Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one)(UILD, ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost(value) sO O 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 co ction an on g. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: / er- Builder Notary as to Owner and /or Condo President My Commission Expires: My Commiss on Expi y PUBLIC STATE OF FLORIDA e'ec~ e0. ii' Cho -" MY COMMISSION EXPIRES 5/09/94 ** * * * * * * .* * * * * * Bonded thru Sterr bler.Adan s & Sweep FEES: PERMIT 3 677 RADON C.C.F. v NOTARY -57a, TOTAL DUE Notary as to Contractor or Owner- Builder APPROVED: Fire Other Zoning Building 01- Electrical Mechanical Plumbing Engineering Date Ll' is fl Job Address �a� � VU - ' S'� Tax Folio WORK DESCRIP'T'ION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description Historically Designated: Yes Owner/Lessee / Tenant ' ` .,o g S 3 `3'o kQs\o e r v-79 Master Permit # ite'VZ....-- Owner's Address to 3 al Nv S _ °1'Z s'� / Phone I S ko - \ O O 6 /75 9/7 Contracting Co. 0'.J v v 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 -T' Square Ft. Estimated Cost (value) I O 0 0 - QC) 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 abov -- • contracto do e ork stated. Signature of owner and/or Condo President Date APPROVED: Z o n i n g Building 4A1 I 4 ' 1 . 1 Mechanical Plumbing 51 A-C/97 Signa ' - of Contractor or gwner- Builder Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder My Commission Expires: My Commission Expires: ( FEES: PERMIT 4-7 °. RADON C.C.F. D NOTARY 5. BOND Electrical Date TOTAL DUE Engineering