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665 NE 97 St (8)Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /de" V 427y Correction Re- Insp'n Fee ❑ //J) Permit No. Name � (� �a— Address � % s 5 / Company Phone # Inspection Date �.S - ' �+ 4 xjl Approved Lf MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request ,O Date Ale-)' Type Insp'n I/19 /V Permit No. /- Name Address .� / 9- 7' 97 Company Phone # Inspection Date 7372-t K aJ Approved Lam' Correction Re- Insp'n Fee Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address . 4 6 .5 t " £ q 7 _5-/ Tax Folio Legal Description 6' ' N t ' 9 7 .s7 Historically Designated: Yes No /3/ �./ ® /2©,/2�rGuL �3 y Owner/Lessee / Tenant ( L � a LJ ' o / AJ 43^ , � Master Permit # q - q Owner's Address. /0, © /') wit, /./, 4 -7/ 1 C /S 1/.1 ?( / L • PL & P hone � ( J�� / J Contracting Co. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL j PLUMBING � MECHANICAL ROOFING PANG FENCE SIGN WORK DESCRIPTION ! �it i1� --e. -e- �G '4./ /., , l4 i< t G•.e, Ltj to ®® C-`'C_ 4,F i L /9 5 t74 i41 4 -3,---t-e-7- epv NC Square Ft. Estimated &Wit 4 751 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 :.� compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date Notary . s to Contract My Commission Expires: Mechanical Plumbing My Commission Exp Structural Engineer Own r- : uilder or • ' ; :,1 VILLAR WARY PUBUCSTATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR 1 BOND FEES: PERMIT RADON C.C.F. t Q NOTARY APPROVED: TOTAL DUET 4 47j Zoning Building 6fri Electrical Date 27 O/ 4 Date 0/ PERMIT NO. ADDRESS: . MIAMI SHORES BUILDING. / ZON VILLAGE NG DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Suble t to carapIlt ci with att Federal, State, Coc-1ty,Wale rt.'fes and reg Iat:s., Wtag, usz,a no responstblllty for accurecy ofloc resat$ from these flans. 2. Thls copy oI plens crust b• avallcbti ca t.B4ing site or no Impaction wtf be condcctad. 4 JOB ADDRESS APPLICANT PHONE # APPLICATION SHEET OF MISCELLANEOUS CRITIQUE SHEET DATE COMMENTS INITIALS NO/.a• aTar -� D• (J/77f c'64ss • /Ati A9 v ,„eaf,/, ti .lzo� . �. r , 3 2' :. �Sq"w.i�'- P /P3 /4 .' y A/0/49. 9° �) • rd-k-n '4 • 9 ' c' • 250'co�� 40, zo 23,0 • � � -ter � � �•Afd Y •"t 7 :: f fE7-97 th- _ - • sToR y 400 .7/ . • • Snr 4 AGE 17 zo 705 WOO ,s /iv 3 1 Type Insp'n Permit No. Name Address Company Phone # Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 6-q- Time Re- Insp'n Fee ? a --S'il7 Jhr/zi WS /flap St / a For Inspector: U 68 F-319d