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938 NE 96 StMIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - /-r4 Time Type Insp'n Permit No. �. " S Name d L /// `"""1. — Address 4) ei; Company 9'l aq i:Atz / ✓/� Phone # 365 5 ri ° x.;24 , For Inspector: ,O 6 Name & D Approved IZl Correction ❑ �C' Re- Insp'n Fee ❑ l2 Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited 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 MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 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. 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, P' 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 Contractor. STATE • F RID .CO TY OF IAMI -DADE ST ..- ✓ FLORIDA, OF MIAMI -DADS Si e of C / ualifier SEAL: / ^ Print Name ` to before me this /(e day of ( l/1/`� Sworn to and subscribed before me this J__to day of Personally known Type of Identification Produce lPct <n. 1 �C Signature of Notary Public - State of -lorida SEAL: PERMIT APPLICATION OR, Produced Identification f �Personally known 0 /C 9 fOlgof Identification Produced: CONTRACTOR New Construction Name ALA, / Name .� License No. f /1 c o 3 e 78/ Alteration Exterior Addres, 7SN 1.4.) / 6 7 Q G Z 27Z, ..4, 7-.2 33c / - - T e l e p h o . 5 04 .e . „ 819_246 9 F a50.f. ,, 812' 3 `>F 6 . Qualifier Names Demolish " °"'"”' New Construction PROPERTY OWNER 1 Name .� /l ni Alteration Exterior Address 8� _ 9 6 , 3 )d 1 - #1-'-' - - 33/3 Home Telepho`>v.c' 7S- 7— /1 S y Demolish BusinessTelepS. 6 5 //22, Fax Foundation Only 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 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 signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted 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. A PPLICATION Job Address:93 8 ///‘ 5 Address Folio Number 11- 3 2. 04 ~Q / —2 c 9O Lot .S 4" et, Block 7 t9 7 Subdivision PB "-' 3 PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. City PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. P4 IJr� Description of Work V' l Gr44-i` /s'r et Zoning Square Feet Value of Work 0 • 1,5 6 Tax Assessed/Appraised Value Flood Zone • 7�D" State PERMIT APPLICATION .1 Zip e'cl �,A/Ye7 Cat€ L car L -/ ;Z re", Linear Feet Units Floors Bldg Value Base Floor Elev. ENGINEER Name License No. Address Telephone Fax ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE. Outlet, Appliance QTV•. i'VPF: Service Repair QTY. A/C Central 1 -3 Ton Fan Soakage Pit Outlet, Wall Bath Tub Service, Temporary Drinking Fountain A/C Central 4 -7 Ton Miscellaneous Repairs Fire Pump Solar Water Heater Outlet, Switch Bidet Signs Filter Replace A/C Central 8 -15 Ton Pool Piping Fixture - Fluorescent Sprinkler Repair Oven Cap - Fixture Space Heater (kw) Fountain A/C Central 16 -20 Ton Pump and Abandon Fixture Light Sprinkler System Parking Lot Lights Cap - Water Spas/Hot Tubs Gas - Appliance A/C Central 20+ Ton Pump, Domestic Flood Lights Supply, AC Well Plugmold/Strip Cap - Sewer Subfeeds, No. of Amps Gas - Natural A/C Window Pump, Fire Stand FPL - Load Central Temporary Toilet Posts Catch Basin Swim Pool, Commercial Gas - Propane Air Conditioners Pump, Re- circulate Garbage Disposal Temporary Water Closet Range/Range Top Clothes Washer Swim Pool, Residential Gas Piping Chiller Pump, Replace - Pool Generators, etc. Urinal Receptacles Dental Chair Switchboards Grease Trap Clear Violations Pump, Sprinkler Heat Recovery Utility - Sewer Refrigerator, Comm. (p/PH) Discharge Well Temp Serv., Construction Ice Maker Compactor Pump, Sump Low -volt, Burglar Utility - Water Refrigerator, Domestic Dishwasher Temp for Test - 30 days Indirect Wastes Deep Freezer Relay Repair Low -volt, Fire Vacuum Pump Renew - Temp Service Disposal Interceptor Demolition Roof Inlet Low -volt, Intercom/Teleph. Water Closet Repair Circuits Domestic Wel: Laundry Tray Dishwasher Septic Connection Low -volt, Television Water Heater Service, Number of Amps Drainfield, 4" Tile/Res. Lavatory MECHANICAL TYPE Minimum Fee QTY. 'TYPE. Condensate Drain QTY. TYPE Generator QTY. TYI'li Refrigeration, Tons QTY. A/C Central, Tons 1 a Cooling Tower Soakage Pit Heating Strips, each Bath Tub Vent Hood, Cost Drinking Fountain A/C Wall/Win. Tons Miscellaneous Repairs Dryer Vents, Number of Solar Water Heater Paint Booth Bidet Ventilation, Cost Filter Replace Air Handler, Tons Pool Piping Ductwork, Cost of Sprinkler Repair Piping, Flammable Liquid Cap - Fixture Periodic Inspections Fountain Barbecue Pump and Abandon Fire Sprinkler System Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Supply, AC Well Pressure Vessel Cap - Sewer Gas - Natural PLUMBING TYPE QTY. TYPE QTY. TYPE QTY. TYPE QTY. A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit 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 Wel: Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater Nov Drains, Area Meter Set (Gas) I Sewer Connection Water Re -pipe Drains, Floor Minimum Fee I Shower Water Service Drains, French Miscellaneous Equi I Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical 9 ..) 6 (• 1C•3 1 - Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ T� © C7 .20 $ (sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (q.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 7 D ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Applicant: Owner: Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 1/16/2002 Page 1 of 1 Contractor BRANDON AC Address: Local Phone: Cellular: Parcel # 1132060142990 Job Address: 938 NE 96 ST Fees: Description Amount FEE2002 - 307 Building Fee $75.00 FEE2002 -310 Notary Fee $5.00 FEE2002 -311 CCF $1.20 Total Fees: $81.20 Permit Status: Approved Permit Expiration: 7/15/2002 Work: DIRECT CHANGE OUT OF AC U ----- If there is no permit package accessible is $50.00, which must be paid in advai this Permit is granted to the contractor or builder nal ordinances pertaining thereto and with the understandir and approved by the proper municipal authorities. This authorization, A further condition upon which this perm ordinances and regulations pertaining to the work cove ,9)G .• by his agents, servants or employees. 1 Signed: In consideration of the issuance to me of this permit, with the plans, drawings, statements or specifications s myself, my agent, servants or employes. Signed: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 5 & 6 BLK 76 LOT SIZE 100.000 X iNnovw NO3H0 SHVI Z 099 09-1:9 18801 Mechanical Permit Permit Number: MC2002 -5 1NROOS1a Construction Value: 1NnoWV SSOus $1,500.00 31vo Total Fees: $81.20 Total Receipts: $0.00 .11E 05 5 680002 CM 0 :1'105000990 :N at BBOt O.(1 SSIEE VcIHO13 'IWVM ZOL a3E rIO 1S3M IWVIW 'V'N 'Iwe1Wp ueg lsruluns — eO — LH s ue , 71)14 lLU ` )6- C - n ,. 1 ITN/ A✓ Q 699Z-619 (90E) 910EE ld 'tWVIW SZ-D '133H1S L9l 'M'N SLL9 'd800 3'11ns.1ne AO H3O110 3H1 01 f ON NO3H0 The Sunshine State — UCENSE KAISER W430 -071-40 -950-0 BETH KAPLAN WALD 938 NE 96 ST MIAMI SHORES, FL 33138 -2624 BIRTH DATE SEX Far. REST. ENDORSE. 12 -10-00 F .6-01 A ISSUED EXPIRES OUPUCATE 10 -16-96 12-10-02 06 -11 -97 SAFE DRNER toes! Operation of a motor vehicle constitutes consent to any sobriety teat required by law. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) ( ,✓E S <7-- 7 k! iL t L6-' Date ; ?/-20 Job Address Legal Description Owner / Lessee / Tenant Owner's Address < j L/ 1 1/ 6 27 � _(7 Contracting Co. 4/1/ M, l � �/j C e;, -ie=6? Qualif ier f e4i State# ; ���, )C?; Competency# Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION - w : 4/7 • ,4f/e- ,/�72.. a, 7!: /( /J /// Square Ft. Estimated Cost /a Cl 6 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 per.-,:its 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. Furthermor =, authorize the above -named contractor to do the work stated. Signa Date: 6/ ure of Owner and /or Condo President la/ Notary as to Owner and /or Condo President My Commiss ion Expires: NOTARY PUBLIC. STATE OF FLORIDA . * * * MY CQb1MISS10N fpoulmli AUK 21. SONDOI'MRU NOTAIrt urginwpmmi PERMIT FEE: APPROVED: Fire Other 51 Zoning Buildin Address Address Address Address Mechanical l§ 3 ) VON Plumbing Tax Folio / / /1/ . /9 > * ; /" Permit # Phone 2 5 2 /('S /5 9(-; A( / %Phone 6 2 Signature of Contractor or Owner - Builder Date: Notary as to Contractor or Owner - Builder My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA 1$1 * * * * MY COMP SIGN EX ES AUG. 21,1991 BONDLD TN NOTARY pU YNOfJ1IAl11 Electrical Engineering Permit No BUILDING INSPECTION DEPARTMENT APPLICATION FOR EL ?DING 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. Owner's Name and Address STATE OF FLORIDA, COUNTY OF DADE. ss. e. Registered Architect and /or Engineer Name and address of licensed contractor WAN VILLAGE 1x7 F Date... F- s�.� - ,191 Z 3 h•CL L- LC) No 93 Street_. L ! (P ST Location and legal description of lot to be built on: Lot 4 Block Subdivision Street and Number whLrc work is to be done �• ' • =- • - - - - - State work to be done and purpose of building (by floors) 9TM- -- 0 U a t b. TGQU ez a'1 L P I c- L uipucT wc. ? ci 6C a cR To 4Q 4 L I1 C Ct)J c2 T-- to c /& and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of f undation Roof Covering Estimated Total cost of improvements $ 6 6 0 , Amount of Permit $ 1 Q_ 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 him in the work to be performed under this permit; and will post or cause to be posted for i pection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub :f; _ • • performed under this permit, as are licensed by Miami Shores Village. II� Remarks (Sig . f-r __ � ) �- Date .t Read, Sworn to and Subscribed before me. 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 an , 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. to me well known, Disapproved / / Notary Public, State of Florida ( Signed) Buffding Inspecfor 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 -ins; ec•tion fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmahip. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR @LNG 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 rdinance 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 a•. building during progress of the work. Owner's Name and Address / Disapproved (Signed) 41 . .1 Date No 5'3 4 Street...41,,.L.:_;..._/. 19 Registered Architect and /or Engineer Name and address of licensed contractor .. ! Wt _i ... a f� Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done . State work to be done and purpose of building (by floors) :. .1 d..... f:...1.; "t`l "..f� / /r+;' At 4, `t . {N . - t d. y + , e and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundajjpr) Roof Covering Estimated Total cost of improvements $ Ck t' ' a 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 pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Pennanent Supplement, and has complied with 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 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 (Signed) % 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 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.._. - ?.' :_._ 4 Date t "'! , Read, Sworn to and Subscribed before me. c y ' Notary Public, State of Florida Buildip _ nspector My Commission Expires PLANNING BOARD DATE Chairman f 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. g° PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / / 947 Job Address 9,3 / 5 Tax Folio Legal Description Owner/Lessee / Tenant t . Owner's Address 9 9 ( r f1 /^ /C <Y 1 1 Qualifier t f C=r4.9,2 L state# Coce ?3t 7 7/ Contractinsco. Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING , - 4`f WORK DESCRIPTION � I. J f � '�" c / Lk/ — Square Ft. Estimated Cost (value) 7 / c� q O , C 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 ace laws regulating construction and zoning. Furthermore, I authorize thp- Bove -named con Signature of owner and/or Condo President Notary as to Owner and/or My Commission Expires: APPROVED: Zoning L Mechanical s FEES: PERMIT 6 11 RADON / e' Date STEVEN! P krig `.'' e%y Cornrr. 6/24/97 Bonded By Service Ins No. CC297479 ereonc'i� Krum ) (Met I. Q C.C.F. / g Address Notary as to Contract My Commission Exp Building 4 1/1I Plumbing Historically Designated: Yes C? No 4'o Vi/ Master Permit # Phone /! / t MECHANICAL ROOFING PAVING FENCE SIGN �z tin/ /V /C d that all work will be done in compliance with all applicable tor to do the work stated. r L Signature of Contractor or Owner- Builder NOTARY fs :PUBLIC Electrical -VEN P WAGNER Gomm Lxp. 6/24 /97 Date Bonded By Service ins No. CC297479 1'�r_onc! y Krum I ) Cthv 1 9. BOND TOTAL DUE / _/ 3 ..1 7 Date Engineering WORK DESCRIPTION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date0- 0 � � Job Address ' .? c[, Tax Folio H b2-U 1421'1 U 0 Legal Description L v r 4 ' p � 77 ( M s • 6 Owner / Lessee / Tenant ;/.?. %d.', / /' Master Permit # VD lQ 2� 1 Owner's Address J A / Phone Contracting Co. 2 . (`r), /�� 6 Address ` 1, S 6: A Qualifier � ("), / ! � '',Phone .1 -?4 4 State 014e6. # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN APPROVED: U Notary h as to Owner and /or Condo President My Commission Expires: Zonin ZE,V4-rg: /VG c//4j Square Ft. Estimated Cost(value , '-( 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 co.plia ce with all appli able laws regulating construction and zoning. Fur ermore, I authoriz- t f :b. e i med o tr -,'td to do the work stated con Signa - o owner d /or Condo President Signature of Contractor or Owner- Builder Date ' Date: 3 otary as to My Commissio FEES: PERMIT 156 RADON C.C.F. 440 NOTARY 0A. I <; TiM Bonded By Service Ins No. CC297479 ** * * * * * * * * * * * * * f -3 er,onett vvn 1 ko her L 0. TOTAL DUE 4 ,440 Fire Other Building Electrical Mechanical : Plumbing Engineering Owner of Building Architect Contractor or Builder - Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ DATF PLUMBING ❑ PERMIT N? 9051 Contractors . . License No 7 ROOFING ❑ ❑ Work to be performed under this Permit 1 Bi. ` 74 BY Subdi- vision Sq. Ft Value of Project $ 4 r_ AUTHORITY Amt. of /� Permit $ 4 195 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 • t t '. 3 ' <�a_- - 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 specification& submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my age sit; servant or employee. 411110,»