665 NE 97 St (2)CONTRACTOR
_
Name t/l //G1(/d! (�V ; /;4°` ji
Name • 0- , A f
f
License No. 0, t ti / �
T //
Home Telephone
Address � e yO t /1)&v 3 7
Fax dr/ , .0
TelephoneVr.,Zpq„2sg
?6
Qualifier Name ALj o / �� — C, w
Fax
PROPERTY OWNER
_
Name t/l //G1(/d! (�V ; /;4°` ji
A d d r e s s , OC
f
r
Home Telephone
'Repair
Business Telephone
Alteration Interior
Fax
Relocation of Structure
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
'Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
Job Address:
GG s
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
v
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
Address
Tele
e
Fax
• • • • • • • • • • • •
• • • • • • • • • • • • • •
• • • • • ..• • • • • •
• • • • • • • • • • • •
• ..•. • • • • .••
Master Permit No. • • ' S li y $e i ;t N;
• • .. • • •
•. • • • •.••
• •. • •
PERMIT APPLICATION
.I.3? 03. -5)
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1. Complete the attached permit application which must be si$Ned lf' lie genveirrirr and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your appliontien. :Ifiroofin •wort 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
City
Address Apt.
Folio Number 1/ 3Zc4Oi7 /4 /O Description of Work
Lot 70 c ( 1 Block AV
Subdivision Al ' ' - • PB / /� , � PG P i Zoning Linear Feet
/
Current Use of Property .. t,d-eziie " Square Feet ,..e- ------. Units
Proposed Use of Property ° "G Value of Work 4 to Bldg Value
Tenant Information
Tax Assessed/Appraised Value
State // Zip
H, h weo i / 'i ,c
Floors
Flood Zone Base Floor Elev.
ENGINEER
Name
Address
License No.
Telephone
F
Page 2
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0 0 0 0 0 0 0 ••• 0
•
PERMIT APPLICATION
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOU1 HAV11Ci RECFsIV�D YOUR 44L4DATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRucnolst are f mired 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 MAI1:TgINEp IN 9 CLvoT, lik AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHAR BE I tEl FFEWILON DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY€( JIPM£NT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
. •
required for work in or near the street/sidewalk • re: •• o • • • • o o • 00
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.
1.
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 Contra tor. / /
•
OUNTY OF MIAMI -DADE
Print Name ,
Sworn to and subscribed before me this 2-4 /day of / /e /�" //
3.
-(4/
SEAL:
Signature of N
ANA M. TORRES
My Comm Exp. 4!512003
No. CC 843457
(1 P¢asanal y Itno m 1100ws 1.D.
Personally known
Type of Identification Produced:
OR, Produced Identification
i S ' AT • FLORI iff • UNTY OF MIAMI -DADE
0 ,. �11.A
?"? . t Contractor / 1 • alifier
Print Name
Sworn to and subscribed before me this Z day of M4/ ,
Signature of
SEAL:
214,40 efig
ntary Pnhtic - State of Florida
ANA M. TORRES
My Comm Exp. 4/5/2003
No. CC 843457
11 Personally Known I) Othe I.D.
1
Personally known OR, Produced identification
Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY
TYPE
Dryer •'
(1T1
•
11 PI
Outlet, ttpinia ce
QTY
TYPE
Service Repair
Q"1'Y
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
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 'Bibs
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
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYPE.
Generator
QTY.
TYPE.
Refrigeration, Tons
QTY.
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
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TY'I'E
Miscellaneous Fixture
QTY.
TYPE
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
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• •• • • • • • •
••• • •• • • •••
• ... • • • • • ••• • • • •
•
PERMIT APPLICATION
•
• •
•
INSTRUCTIONS: Please indicate the type of work berg per;oimed and gtiantity(ies) in the space provided below.
• RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
•• • • • • ••• • •
• . . --
• •
o 0
000 0
1 I 1 IN
• 0•• • 0 0
O 0• 0 0 0
o 0 • 000 0 0
•• • •• • • •••
• • • ••• •
• • • • ••• • • •
CHECKLIST
❑ PROOF OF OWNERSHIP
•o •(4ttaG • • • ee
e • • • • • • • o
o •• • • • • ••• e
•
• I-1Ri /AR I2O3/ oL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
$ 69'O , IX)
Metropolitan Dade County (C.C.F.) $ / e 6L 0 (sq.ft. = x/1000
x ¢.60)
Inspector State Educational Fund $ (¢.005 /sq.ft.)
State DCA (Radon) $ (¢.01 /sq.ft.)
Code Enforcement Fine $
Zoning Review
Notary
BY
SECTION
Zonin
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ I ' L)
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL G (305) 795 -2207 C FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
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LEGEND:
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ABBREVIATIONS:
AL - ARC LENGTH
- CENTER LINE
CF - CALC FROM FIELD MEASURE
CR - CALC FROM RECORD INFO
DB - DEED BOOK
DE - DRAINAGE EASEMENT
DME - DRAINAGE MAINTENANCE EASEMENT
0 - CENTRAL ANGLE
EASE - EASEMENT
F.F. - FINISHED FLOOR
FND - FOUND
FPL - FLORIDA POWER & LIGHT
L - LEGAL
DENOTES ELEVATION SITE
t l o (p
DENOTES FENCE LINE
DENOTES WOOD FENCE LINE
II_
GlLD1 -L it
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OHC
ORB
P
PC
PCC
PCP
PK
POB
POC
PRC
PT
RNV
RP
SBR
UE
W/C
W/M
LaT 5
Fit.o c.•tc., S o
- MEASURED
- OVERHEAD POWER CABLE
- OFFICIAL RECORDS BOOK
- PLAT
- POINT OF CURVATURE
- POINT OF COMPOUND CURVATURE
- PERMANENT CONTROL POINT
- PARKER KALON NAIL
- PROPERTY LINE
- POINT OF BEGINNING
- POINT OF COMMENCEMENT
- POINT OF REVERSE CURVATURE
- POINT OF TANGENCY
- RIGHT OF WAY
- RADIUS POINT
- SOUTHERN BELL RISER
- UTILITY EASEMENT
- WITNESS CORNER
- WATER METER
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CERTIFICATIONS:
NANCY DOWSON
LISA I. GLASSMAN, P.A.
RAPID TITLE SERVICES
ATTORNEYS' TITLE INSURANCE FUND, INC.
ABN AMRO MORTGAGE CORPORATION, ITS
SUCCESSORS AND /OR ASSIGNS
W 90
W 89
INVOICE # 02 -15442
PROPERTY ADDRESS:
454 NE 93 STREET, MIAMI SHORES, FL. 33138
LEGAL DESCRIPTION:
LOT 6 & THE WEST'''/ OF LOT 5, BLOCK 50 OF "MIAMI
SHORES SECTION 2" ACCORDING TO THE PLAT THEREOF,
AS RECORDED IN PLAT BOOK 10, PAGE 36 OF THE PUBLIC
RECORDS OF MAIMI -DADE COUNTY, FLORIDA
FLOOD ZONE INFO:
COMMUNITY # 120652 LOWEST FINISH FLOOR: N/A
PANEL & SUFFIX 0093 J GARAGE: N/A
FLOOD ZONE X N/A
DATE OF FIRM 3/2/94
NOTES:
1. THIS SURVEY IS BASED UPON RECORDED INFORMATION AS PROVIDED BY
CLIENT. NO SPECIFIC SEARCH OF THE PUBLIC RECORD HAS BEEN MADE BY
THIS OFFICE.
2. UNDERGROUND IMPROVEMENTS HAVE NOT BEEN LOCATED EXCEPT AS
SPECIFICALLY SHOWN.
3. ELEVATIONS ARE BASED UPON NATIONAL GEODETIC VERTICAL DATUM 1929
(N.G.V.D. 1929).
4. FENCE TIES ARE NOT CENTERLINE OF FENCE.
5. IN SOME CASES, GRAPHIC REPRESENTATIONS HAVE BEEN EXAGGERATED
TO MORE CLEARLY ILLUSTRATE MEASURED RELATIONSHIPS- DIMENSIONS
SHALL HAVE PRECEDENCE OVER SCALED POSITIONS.
6. ALL DIMENSIONS SHOWN ARE FIELD MEASURED AND CORRESPOND TO
RECORD INFORMATION UNLESS SPECIFICALLY NOTED OTHERWISE.
7. DATE OF ORIGINAL FIELD WORK
REVISION SCHEDULE:
SURVEYOR'S CERTIFICATION:
I HEREBY CERTIFY THAT THIS
SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS FOR SURVEYS, AS
SET FORTH BY THE FLORIDA BOARD OF SURVEYORS AND MAPPERS IN
CHAPTER 61G17 -6 OF THE FLORIDA ADMINISTRATIVE CODE, PURSUANT TO
SECTION 472.027, FLORIDA STATUTES.
SIGNED:
Richard W am, Professional Survey & apper
Florida Registration No. 6066
(not valid without the signature and original raised seal of
the Florida Licensed Surveyor and Mapper shown above)
;
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BOUNDARY
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PK. BLVD. ° SUITE 108 0 LAUDERHILL, FL 33313
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LEGEND:
a 4 IS— DENOTES FENCE LINE
DENOTES ELEVATION SITE
ABBREVIATIONS:
AL - ARC LENGTH
- CENTER LINE
CF - CALC FROM FIELD MEASURE
CR - CALC FROM RECORD INFO
DB - DEED BOOK
- DRAINAGE EASEMENT
- DRAINAGE MAINTENANCE EASEMENT
- CENTRAL ANGLE
- EASEMENT
- FINISHED FLOOR
- FOUND
- FLORIDA POWER & LIGHT
- LEGAL
I VI (I)
DENOTES WOOD FENCE LINE
0
M
OHC
ORB
P
PC
PCC
PCP
PK
R
POB
POC
PRC
PT
RAN
RP
SBR
UE
W/C
W/M
b (� ) ( 11 )
II
to t I1
4
t.oT 5
Pew cac. S o
wt efy
51• o'
- MEASURED
- OVERHEAD POWER CABLE
- OFFICIAL RECORDS BOOK
- PLAT
- POINT OF CURVATURE
- POINT OF COMPOUND CURVATURE
- PERMANENT CONTROL POINT
- PARKER KALON NAIL
- PROPERTY LINE
- POINT OF BEGINNING
- POINT OF COMMENCEMENT
- POINT OF REVERSE CURVATURE
- POINT OF TANGENCY
- RIGHT OF WAY
- RADIUS POINT
- SOUTHERN BELL RISER
- UTILITY EASEMENT
- WITNESS CORNER
- WATER METER
powE.e
rock.
0' PROPERTY ADDRESS:
454 NE 93 STREET, MIAMI SHORES
0
0
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0
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4
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NOTES:
1. THIS SURVEY IS BASED UPON RECORDED INFORMATION AS PROVIDED BY
CLIENT. NO SPECIFIC SEARCH OF THE PUBLIC RECORD HAS BEEN MADE BY
THIS OFFICE.
2. UNDERGROUND IMPROVEMENTS HAVE NOT BEEN LOCATED EXCEPT AS
SPECIFICALLY SHOWN.
3. ELEVATIONS ARE BASED UPON NATIONAL GEODETIC VERTICAL DATUM 1929
(N.G.V.D. 1929).
4. FENCE TIES ARE NOT CENTERLINE OF FENCE.
5. IN SOME CASES, GRAPHIC REPRESENTATIONS HAVE BEEN EXAGGERATED
TO MORE CLEARLY ILLUSTRATE MEASURED RELATIONSHIPS- DIMENSIONS
SHALL HAVE PRECEDENCE OVER SCALED POSITIONS.
6. ALL DIMENSIONS SHOWN ARE FIELD MEASURED AND CORRESPOND TO
RECORD INFORMATION UNLESS SPECIFICALLY NOTED OTHERWISE.
7. DATE OF ORIGINAL FIELD WORK
l td$
INVOICE # 02 -15442
LEGAL DESCRIPTION:
LOT 6 & THE WEST A OF LOT 5, BLOCK 50 OF "MIA
SHORES SECTION 2" ACCORDING TO THE PLAT THEREO ,
AS RECORDED IN PLAT BOOK 10, PAGE 36 OF THE PUBLIC
RECORDS OF MAIMI -DADE COUNTY, FLORIDA
CERTIFICATIONS:
NANCY DOWSON
LISA I. GLASSMAN, P.A.
RAPID TITLE SERVICES
ATTORNEYS' TITLE INSURANCE FUND, INC.
ABN AMRO MORTGAGE CORPORATION, ITS
SUCCESSORS AND /OR ASSIGNS
FLOOD ZONE INFO:
COMMUNITY # 120652 LOWEST FINISH FLOOR: N/A
PANEL & SUFFIX 0093 J GARAGE: N/A
FLOOD ZONE X N/A
DATE OF FIRM 3/2/94
REVISION SCHEDULE:
SIGNED:
SURVEYOR'S CERTIFICATION:
1 HEREBY CERTIFY THAT THIS
SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS FOR SURVEYS, AS
SET FORTH BY THE FLORIDA BOARD OF SURVEYORS AND MAPPERS IN
CHAPTER 61G17 -6 OF THE FLORIDA ADMINISTRATIVE CODE, PURSUANT TO
SECTION 472.027, FLORIDA STATUTES.
BOUNDARY
P 4' 41f/
Richard I BibI$Kam, Professional Survey & upper
Florida Registration No. 6066
(not valid without the signature and original raised seal of
the Florida Licensed Surveyor and Mapper shown above)
PERMIT IT? 11968
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
(
tot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Work to be performed under this Permit
Moir
Bl.
Subdi-
vision
Value of
Project $
DATE r' 195
kq
Contractors �
a ,
License No
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: BY
INSPECTOR
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 responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Date Time
Type Insp'n
Permit No.
Name
if Address
4 Company
Phone #
For Inspector:
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
U O3 _
ROOFING ❑
MECH ❑
Own of Ir u. f Z f,;l /ILIJ 0 -k0 d P 1 Budding er j �
Architect
Contractor
or Builder
Legal
Description
ption
Address of
Building
p t �- E 7 {i BL%Y PR /as
CONTRAC
R or BUILDER
MIAMI SHORES VILLAGE, FLORIDA
BUILDING
P UMBI D PERMIT N_ 48744
Work to be performed under this Permit
Date
Contractor's
License No.
'7 —/® 20 _V__
/14 l iboL
Su62 s6/ /
vision) 1 3 X06.6/'T •i fl0
Sq. Ft.:
Value of
Project $ VV
Permit: p2 20.
CCF: / ((!
Notary:
Bond:
Radon:
Amount of , �1
Permit:
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that . the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. `
Signed " y / 1 (INSPECTOR) BY
In consideration of issuance to me of t alts permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
perta
cceptin!� � sibility the
o all work done by either, myself, my
specifications age servant or employ
teeoper authorities of Miami Shores Village.
In
BY AUTHORITY
Date
Type Insp'n
Permit No.
Name
Addre
For Inspector
Approved
Correction
MIAMI SHORES VILL
BUILDING DEPARTME
305- 795 -2204
Building Inspection Request
Time
Company
Phone #
W3 ) - 671,_.)
/Nip
Re- Insp'n Fee ❑
, be
1
MIAMI SHORES VILLAG.
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'. 5 / -P%4) ,.{/✓1�
Permit No. II L7 (70
Name
Address466e &-e
Company
Phone #
For Inspector
Approved
Correction
Re- Insp'n Fee
b„L., Name ate
1[247-
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date _ Time
Type Insp'n `f c / - -6
Permit No. i . 0Q100 ' lx 3
Name 7/1/:t&A/
Address 5_ NV 1q 37E
Company Al riAaA, l Y ,., �J ? Ora f Q Phone # 3 05 ' q � I a
For Inspector:
Approved
Correction
Re-Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ing,}i spection Request
e "Time
Date
Approved
Correction
Re- Insp'n Fee
Type Insp'n ,,��^^�� Q
Permit N67,� 00.2 ' U
Name 21)17244/(__,
Address l Q 49_5
Company _�� -' - - -- -- - - - - -- '
Phone # 0,5& 9 9 O' c' /
For Inspector: Oame & Date
6
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date / / me
Type Insp'n
Permit No.
Name _-!t
Address
Compan
Phone B Ct - 0, R)),
For Inspector: /73// 0 Name & D
Approved
Correction
Re- Insp'n Fee
Address
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
D Mme
Date
Type Insp'n r /
Permit No. )1 0 ° a� 4CY
Na) erg 4*
Company
Phone # r oS A-9 3o1,?
For Inspector: ) 1 ° a dame & Date
1
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date — d Time
Type Insp'n ✓2
Permit No.
Name
Addreis
Company
Phone #
For Inspector: _ 0 _p Name & Da e_
Approved
Correction
Re- Insp'n Fee
C
r /2Jf? 7 ,51'
4k,4
v7z
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date / Tim
Type Insp'n 1 D v
Permit No. 6, 0
y Name _7
Address
Company
Phone #
For Inspector:
Approved
Correction
Re- Insp'n Fee
Name & Date
Date Time 4 1E - Type Insp'n 11 L/ ` �
Permit No.
Name _
6 17
Address
Company ,, /
Phone # ! � l ( Q / • /
For Inspec
Approv
Correction
Re- Insp'n Fee
I t,ct,d /A.
ceft,z0, 51441—
a "74.5 if
A O •1e-P
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MIAMI SHORES VILLAGE
BUILDING DEPARTM
305- 795 -2204
Building Inspection Request
Name & Date
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B ']din: Inspection Request
Date ' 1
�j r 1 a p hc5+ t'
Type Insp' n I 'v t T
Permit No. - 1 473
`�
Name Ie o
Address D5 i vF . `1 f M
Company x-1.1 1L
Phone #
Inspection Date 1
Approved
Correction
Re- Insp'n Fee
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B 'Wing Inspection Request
Date l
`1 1 1\9C hoi
y1C)
Type Insp n �.t
Permit No.��
Name El flirty)
Address V � .
Company tiLa \l
Phone #
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B 'Ming Inspection Request
Date 3l Time
Type lnsp'n ' POO
Permit No. Vi 2O (3 - 100
Name U. Mitt
Address 0 (0 5 Qt.
For Inspector: 6P g `
Approved
Correction
Re- Insp'n Fee ❑
Name & Date
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bidding Inspection Request
Date A tl ✓ I Time
Type Insp: n r nct' Gbc 1
Permit No. fi5P 2o03 3 - 100
Name W h I l l Ce
Address 0 (05 kU E- 1 S
Company Q r �
Phone # q54 ^ 6 � L)
For Inspector: 6 r ' Name & Date
d s
Approved
Correction
Re- Insp'n Fee ❑
L
Correction
Date Ti ] /
Type Insp'n P i v
Permit No.
Name
Address
Company
Phone #
For Inspector: j /
Approved V e
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection R
Datt
Type Insp
Permit No.
N
Address 6 6 S °* � -� 9, fl
Companni, �i ,r/ I i? 1t cit -1
Phone # 30 C "— M-'106 b
For Inspector 211 DCC Name & Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
5110
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B uil ingInspection Request
I
Date
Type Insp'n /�/ ° ' I \""k
Permit No. ' / V a�O `�l
Name �C Q IQ zC
s scri 54
5
Address
Company
Phone #
Inspection Date �(-
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 - 2204
Buil ing,Inspection Request
Date
Type Insp'n r } / l / i
Permit No. ! - Pair 56
Name rPV)CV7 /C
Address l[J � S )54 5
Company t,L 5S
Phone #
Inspection Date
Approved
Re- Insp'n Fee
Correction ❑
Date
Type Insp'n
Permit No.
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Address K :3 ,f/ig_ q7 5r
Company
Phone #
Inspection Date
Correction
Re- Insp'n Fee
o i�
MIAMI SHORES VILLAG
BUILDING DEPARTMEN
305- 795 -2204
Building Inspection Request
Date Time , �
Type Insp' n G- ,it,• -- ✓ a.%1
ow Permit No. eQ •
Name
lti Oii //C '' ' Q( 9
Address. _ '' q S
Company
Phone #
For Inspect :
Approved
Correction
Re- Insp'n Fee
Ize/ /%Qci
to