822 NE 96 St (6)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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.
Date t ri ° ,-)^ `1 — :l° c , 19
Owner's Name and Address No Street
Registered Architect and /or Engii er
Name and address of licensed contractor - -IAL .
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State wpr to be done and p urpose of building (by
Notary Public, State of Floric.a
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 $ D, 0...5 -- ,,- Amount of Permit 4 S
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 similar compliance from all contractors or sub - contractors employed by hin-
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 ublic 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 g )_L- - I 4_ t
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 stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector 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.
To be constructed of
Estimate Total cost of improvements $ erd' ®CU
Zone cubage required
STATE OF FLORIDA,
COUNTY OF .DADS. ss.
Disapproved L , � ..- ... - -.. Date..
(Signed)
Building Inspector
MIAMI SHORES VILLAGE
Kind of foundation
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or 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 iuilding 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.
Date...: .________
Owner's Name and Address 0.di 10 - 5 L' _.._., ?... :�' �� o.... » ».... ........_... Street_._
Registered Architect and /or Engineer ••. .
Name and address of licensed contractor.
Location and legal description of lot to be built on:
Lot Block Subdivision ._._
Street and Number where work is to be done ,_r2 "
State work to be done and purpose f w ilding 1 y floors)
(Signed)
3
. �_......__ _.....__...._.... ,19 0
VI* V .f VI 1:
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
Roof Covering
Amount of Permit St
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 5e966, Compiled General Laws of Florida, Permanent Supplement,
and has complied w ith 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work t. , . performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally r,p•
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 farts
therein by him stated are true..
Permit No. . 1 Date N t - C Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known,
My Commission Expires _......._........ �.
PLANNING BOARD DATE
Cirair:nan Member
Mereber Member
Member Member _.._
Council Approved Date Disapproved Date
NOTE: A charge of 51.00 will be made for making corrections or changes to this application niter approval has been obtained from
the PI.rnnir.g Board.
A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
MAY
r i. "' '1
4 FASTENERS
PER BOARD
e FASTENERS
PER BOARD
® FASTENERS
FIR eOARO
r °t' .g•
I 12 T ' 1
_1.
r
.DIMENSION PER FASTENER OR AOAaD MANUPACTURRR
g PER S BOARD
FASTENERS
PER BOARD
I� y '2- -r 4:•
,12 FASTENERB
PeR BOARD
DACE COUNTY
B U I L D I N G CODE COMPLIANCE OFFICE
PROTOCOL PAI17 -94
FIGURE 3
FASTENER PLACEMENT 4' X 4• BOARDS
g ri ^+ F G' STiz�
Page -18 PA 1 l7 .
4
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ,5"- ( Job Address f,; , - / ( i ) pt Tax Folio
Legal Description
Owner/Lessee / Tenan
Owner's Address v Alf
State # Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Square Ft. do _CI
Historically Designated: Yes
Competency #
Address
Address
Address
Master Permit #
Contracting Co. J, Q7 e. �5 ��' a �'�� / f C Address 'A- . //t
Q ualtfiere / c ", ` �% e/ L " G✓° � SS# 2 /- -,' - Phone a ry ' :3'
/
Phone
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ME HANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Estimated Cost (value/
Ins. Co.
No
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 applicabe). 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 above -named contractor to do the work stated.
actor or Owner -Build Date
otary as to owner and/ •r Condo President
My Commission Expires:
GEORGIA PANTELIS
A. MY COMMISSION # CC 236055
EXPIRES: October 15, 1996
p„ ,o.,, Bonded Thru Notary Pubic Underwriters
FEES: PERMIT RADON
APPROVED:
Zoning
e of owner and/or Coai President Date
Building
Date
Signature,of Co
Not as to Contr tor or 0 ' er- Builder
My Commission Expires:
C.C.F. l� NOTARY
?
; 40F1rc 4 MY COMMISSIO PANTELIS CC 256055
' 1 EXPIRES: October 15, 1996
Bonded Thru Notary Public Undenw$ters
Electrical
TOTAL DUE
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR M
Date 9/28/99 Job Address 822 N.E. 96 Street Ta
Legal Description Historic: I
Owner/Lessee / Tenant Ana & Tom Hu r s t
Owner'sAddress 822 N.E. 96 Street, Miami Shores
Qualifier Edward F. Holman, Jr.
FEES: PERMIT
RADON
Notary as to Owner and/or Condo President Date
My Commission Expires:
Notary as to Contract
My Conunission E
C.C.F. 1. O D NOTARY
Phone
Square Ft. Estimated Cost (value)
(305)756.-8191
Contracting Co. Roof Painting by Hartzell, Inc. Address 2329 Pembroke Rd. , Hollywood, FL
SS# 261 - 15 -3464 Phone(954)922-1006 l"
State # 116000-1 Municipal # 30-1160001 Competency # 000014657 Ins. Co. Furman Ins.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Exterior Painting of house 1;/4-0
rl4 : 444.41.L
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO 1)O 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 11 work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to dpwork stated.
Signature of owner and/or Condo President P.: to Si Q 7 ture of Contractor or Owner- Builder
c 4 --e.e..3 di? &14/0/10E)
9.2 ?e9
er- ifidlt t t' t': • Date
P!i : 4S ru :cars
I:. I t'dS9
BOND
to t og 7 #,
Date
U
APPROVED: TOTAL DUE
Electrical
Zoning Building `�' / 1"
� �g ` 6
Mechanical Plumbing Structural Engineer