ROOFPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date 11-7 Job Address /oaO /UE q9 57
Legal Description ti
Owner / Lessee / Tenant grail y SUJG,0p
Owner's Address
Contracting Co. f L., S eiP,14, l/ Address di 70
Qualifier J1O1')2i► ± Sp fd SS ##
r 3 -7 0
State4f 0,00a - 6 7
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICALL PAVING FENCE SIGN
WORK DESCRIPTION AI- gd -,,-e 40� aucc,it SPG , S
Square Ft . 0
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 author the above -named contractor to do the work stated.
Signature- o
Date:
Notary as to Owner and /or Condo Presi.ent
My Commission Expires:
NOTARY PUBLIC STATE OF FLORIDA
* * * *9Y COMMIS *ON EXP J*iE 24,199*
$ONDED THRU GENERAL INS. UND.
PERMIT FEE: APPROVED: Fire
Zoning
Competency #
Building
Mechanical Plumbing
P(.-7s3 's 19 91
1
Address
Address
Address
oo
Estimated Cost g 600,
gna ure of Contractor or Owner- Builder
Date:
Tax Folio // -Q O3 - Coo-a°
Master Permit. #5/91/
Phone (C / _ / `_
OPT ��� 6/v,
Phone C!/ gl 02(0 - 7
Ins. Co.
Notary as to Contractor or. in
ti
er- Builder
My Commission ExpiresdOTARY PUBLIC STATE' OF FLORIDA
* * * ` * COMM •i EXP U* 24,1999w
BONDED T :NE •, '. ND.
Electrical
Engineering
NOTICE OF 2 —
COMMENCEMENT r,
Permit Mo. - a / Ci ( Tax Polio No. // -32 O-
- c 03 - 002 0 7 ;_,
.
STATE OF FLORIDA r
COUNTY OF
0
The undersigned hereby gives notice that improvements will be made to certain real
property,and in accordance with section 713.13 of the Florida Statutes, the following o
information is provided in this NOTICE OF COMMENCEMENT. ,+
Legal description of property (include street add ems, if available) 11
10.)o. ft r ) Yq 51 J1 X,"„77h/ Li
ri
General description of improvements/V i/► 4X IVA S1 S n e��ly d-- V f4vj �y
Owner F m, I y sln cti VSO r l
Address I oa a ICJ E 'Ft S
Owner's interest in Bite of the improvement
Fee Simple Title holder (If other than owner)
Name
Address
Contractor
Address
Surety
Address
Name
Address
Name
Address
D 1\ Ak> e)A-' /IC a.
(1) Ofr ka.ko. 61v)
Amount of bond $
Any person making a loan for the construction of the improvements
Person within the State of Florida designated by owner upon whom notices or other documents
may be served as provided in Section 713.13(1)(a)7, Florida Statutes.
In addition to himself, owner designates
Of
to receive a copy of the Lienor'e Notice as provided in Section 713.13(1)(b), Florida
Statutes.
Expiration date of Notice of Commencement (the expiration date is 1
recording unless it different date is specified).
THIS SPACE FOR RECORDER'S USE ONLY
9 P
'D/ 70 oQ, �` c,��c ie,)I
O P4 ��� s r �� 330_ i<
stJ\'tt Or FLORIDA
COUNTY OIL DA
I HEREBY C
original f
c7 — J
, A D 1a
WITNESS my hand and Official Seal.
that this Is a
this Office on
Clerk Circuit Co rt
SIG TURE OF OWNER
Lm,. /y 4, gAci/nD
PRINTED SIGNATURE OF OWN R
SWORN TO AN SUBSCRIBED BEFORE ME THIS
DAY OF /Vac'', 19 _a_..
df the
D.O.
year from the
date of
Ns ARY PUBL
PRINTED NOTARY 8iN FLORJOA
MY C(:.:1 XP LUXE 24,1%6‘))
MY COMMISSION EXPIRES Bi0,WE0 Trif,U i:, "•:el-�fl p44. uND.
0
Application is hereby epode for the approval of the detailed statement ur rme plans and specifications herewith submitted for the build •
ine 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.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contactor Obenotut %2oouut Co. 7357 N.
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
State wort to tie dgne a d purpose /
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
buyilding
an
Ncw Building Remodeling
S bdi ision
0201. . 99 S.
by floors) .. ?emvve nool i.rtg. on sita>vet 4.ectkvn and neEiace w.i trt
g..■cayel rcvoing.
and for no other purpose.
Addition........ Repairs X No. of stories
Kind of foundation Roof Covering
20.00
To be constructed of
Estimated Total cost of improvements $ 1200, 00
Zone cubage required
Building Inspector
NOTE: A charge of $1.00 will be made for making corrections or chn
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection i
materials and /or workmanship.
11 ....._ 8�
No... _ eet_.. � _ `99
Amount of Permit S
plan Cubage
.... „,... ...• . I • . ,.,. ».. ,• ,., :,. :[ ¢.
dearer C lrl<.anii.;
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 lahur under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supple
and has complied 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 are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA, 1 .
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 e.. I
Permit No.._..II 2 Date.... .1. .._.. !......._._ Read, Sworn to and Subscribed before me.
n X10
Disapproved _ �\...���...�.�. Date
(Signed)
My Commission Expires
PLANNING BOARD DATE
Chair :nan Member
Merober Member
Member .. .. Member
Council Approved Date Disapproved
nges to this application after approval has been obtained from
s made necessary by Improper notice for inspection or faulty
Notary Public, State of Florida
Date
Owner's Name and Address._ Tan R. Claussen
Registered Architect and /or Engineer
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 , 19
e5th St.
No 1005 N.
Str
Name and address of licensed contractor `Brady Roofing & Sheet Metal x' N. W.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done `1:020 N. E. 99th St.
State work to be done and purpose of building (by floors) Roof: 30 -90 -Tile
73rd St.
and for no other purpose.
New Building X Remodeling . Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering Tile
Estimated Total cost of improvements $._ 97.5..00 Amount of Permit $ 7
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 empl d by him
in the work to be performed under this permit; and will post or cause to be posted for i .pectio on the site of the work such )lic notice
or notices as are required by the Act. The undersigned agrees to employ only such s • ontra vbork to be perfo 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 /L_-�C• __L? Date /� O 4/ Read, Sworn to and Subscribed before me.
Disapproved
(Si Signed) �1
g ) ham !� ..:.. , :_: , •--. !_.. .��f
Building nspec
My Commission
Notary Public, State of Florida
Expires
P . NING 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.