MECHANICALy PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date tl — — 5UJob Address Ale Hq � , Tax Folio
Legal Description Historically Designated: Yes v No
Owner/Lessee / Tenant /- --. /%f , 4-f Master Pennit # /' 3 C ( 7j /
Owner's Address /c2 /rf x/ , 9 ,S 174- - Phone 'k - ( 3 513 •
Contracting Co. 4-/04f/
Address / N - /O 9 S 1- .
Qualifier £ /4'A"Ir 8- 9 9' --//e7_
State # ,¢eC / S 9 Municipal # Competency # Ins. Co. /= T/ 4° .
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANICAL ROOFING PAVING NCE SIGN
WORK DESCRIPTION 'NS e...1,44-11.) /4 � � f 04)1 ,4/d._ s7 7 • J
Square Ft.
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 authorize the above -named contractor to do the work stated.
Srgn
6
otary as to
My Commis
APPROVED:
Zoning
Mechanical
o v
esident P ate
i s i - .:�.:.. •
r .a n Date
\ail/ /, //
Na x�ppr�r r . } YSl
k FOLIC STATE OF FLORIDA
COMMISSION NO. CC.'
MYCOMMISSIC
— 7
Building
i
Z1Plumbing
Estimated Cost (value) 3 S'DO. U O
c
Signature of
CU"
Not as to Contracto
My Commission
or' f 'Idet`
�t eS 'rJRL CSTA EOFFLORID
CO2viMISIOfl! NO. CO7I4903
AYC01∎4 {ISSIONE'XP. MAR.i,2002
Date
a.. 79t - s .i32f- v
E-al- yr
Electrical
Date
NOTARY 500 BOND
TOTAL DUE lDZ .
Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
gam,
Owner / Lessee / Tenant Ujvgl L1
Legal Description
Owner's Address / n, L -E- g'
Contracting Co. 'Zf i -
Qualifier _ N. 2b SS# -
State 4 L.
Architect /Engineer
Bonding Company
Mortgagor
Job Address
9
(OWNER TO RETAIN COPY)
Competency# O ?I
Address
Address
Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING
Square Ft.
SigEattre�of Oder an • /or ondo President
v
/. rJ /G 7V /l1/
Notar nsito Owner and /or on o President
My Commission Expires: /, /6
* * * * *
Date:
PERMIT FEE: APPROVED:
Master Permit # ..j/s15
Phone
iD7 /S Skid (90 s( 43
Phone 2
Fire Other
Zoning Building Electrical
umbing Engineering
Tax Folio/ /.' t6' 6'
Ins. Co. s f , A 4 iv f'1T'
PAVING FENCE SIGN
WORK DESCRIPTION TCp j /z /o,c! PiQ' AG?-a / M t_3- 1
Estimated Costga
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 authorize the above -named contractor to do the work stated.
Signature of Contractor or Owner - Builder
Date:
Notary as to Contractor or Owner - Builder
My Commission Expires:
* * * * *
* * *
Lot
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 building 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 IAA my Nit v A A'a,ret s No. 1 I S Street /V G/ ?TJ .=,-7
Registered Architect andior Engineer
Name and address of licensed contractor Sky-Ray i e- 1071c 51,J OQO STIZ 33 VI 04-4A( _
Location and legal description of lot to be built on:
Block Subdivision
Street and Number where work is to be done 1:).1? ) Q ST
1
) S to work to be done and purpose of building (by floors). state exterior colors (submit samples) � L!�} C- 3 Z "T� 1&)
/,c _VA& E A Goa c T f 1+44- A /4iz, D 3 72. - repo /1.
SE, -iz Pik rA4, A _ 0,4 t T
New Building Remodeling Addition Repairs No of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S �7 � Amount of Permit 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 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 obligatons 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 inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only st�cch subcontractors. on work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Signed)
Date f A Aa& - 19 gf_
and for no other purpose.
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me, the undersigned authority. a notar public duly authorized to administer oaths and take acknowledgments, personally appeared
E o �A 2a `T /- 4/4E
and who, being by me first duly sworn, upon oath deposes and says that he is the Al2/1/4
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.
Permit No. Date Read. Sworn / to and Subscrib be fpre me. �� Disapproved Date � f'
6 /Z /f/ Notary Ntiocomtai MAW 03 11.61640A
(Sighed) NV CON C ! EW.0CT.12.19S2
Building Inspector My Commission Expires UG; p TV211 GEbna WA- MTh.
PLANNING BOARD DATE . --
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andhor workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
G
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
o
0
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 7111
Owner of
Building
Y
DATE - 195
Contractor's
License No.
Work to be performed under this Permit
B1
Subdi-
vision
Value of
Project $
Amount of
Permit $
CONTRACTOR OR BUILDER BY AUTHORITY
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 cr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed ,-
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 ac-
cepting this per I assume res sibility for all wor)f done by either, myself, my agent, servant or employee.
.2/ / /
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 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 Addressa- Reh
Registered Architect and /or Engineer r
Name and address of licensed contractor. El./ �/ - 5 q 0"-,( Caier,
Location and legal description of lot to be built on: /
Lot Block Subdiivii ionn
Street and Number where work is to be done l df'
State work to be done and purpo f building (by floors)...( 2E:j f
4 2 , -", VI 1 , '' 2 <rl 6 r -7'
New Building Rernodeling. Addition
To be constructed of Kind of fo dation
and who, bein g
of the above
therein by him
Permit
Disapproved
(Signed) L
//(
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Da�_/
/ • r, _.�
Building Inspector
1
MIAMI SHORES VILLAGE
1
Date
4 g
PLANNING BOARD DATE
vet /T/r/4 Strut✓ — J%
Date y " 7 y ' - Read, Sworn to and Subscribed before me.
11.-
, 19,1
!/ t1 4)1
and for no other purpose.
Repairs No. of Stories
Roof Covering
Estimated Total cost of improvements $ 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 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 inspection on the site of the wo k such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be erformed 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,
by me first duly sworn, upon oath deposes and says that he is the
d escribed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
stated are true.
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Date Disapproved Date
of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
Chainnan
Member
Member
Council Approved
NOTE: A charge
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.
off, e10y
C
(0,&-ef_e_di4L et_„ta.„a,,e -e9
_w_de -
& & r aLty
44,G,
BUILDING INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made fr the
c Tl] son) statnient of the
n and ormity specifications the herewith
Buildin Ordinance the Miaai
Shores Village, e, hen u ide r ions of the e Building Florida, and all proiiof Sho ll rules and
i of the Laws � l the h ro Florida.
t d with, whether herein specified oVillage otA copy
re of approved
regulations "tuil Divi:.i�m of :�.i]ami n s '
plans and specifications must be ketr at building during progress of the work.
Owner's Name and Address
MIAMI SHORES VILLAGE
V 1 4A) CA--0-4-11
Registered Architect and /or Engineer..
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot_ __. Block.
Street and Number where work is to be done_
State work to be done and purpose of building (by floors) !
PLANNING BOARD
Subdivision
No Street.
Date
Addition._.. _.__ __ _._. __ -_ Repairs.. _ . .. - No. of Stories
Roof vering__
,19
p
1-t . t _ to or no other purpose.
New Building_ . Remodeling_
To be constructed of _ _ _ . . . . . . . K i n d of foundation.
Estimated ". ,tal cost of improvements $__. 6 - -7'
Amount c f Permit $
Zone ^ubage required _ -- .. - - -- - -- - -- - -- -
.Plan Cubage
Distance to next nearest building__ _._
Size of Building Lot -- -- - -
Maximum live load to be borne by each floor
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 unde signed appli ant for this building permit does hereby certify hat he understands and accepts his obligations as an employer
of 1• bor under he Florida Workmen's Compensation Act, being Scrtion 5966, Compiled Gem al Laws of Florida, Peroanen; Supple cent,
and h s compl ed with he prov :ions thereof, and will require similar con]nliance from all contractors or sub - contractors employed by him
in the wo k to be p rf -med under this permit: and will post or cause to be posted for inspection on the site of the work such public notice
or ,.oti es as are requ]r d by the Act. The u.,dL r.rgned agrees to employ only such subcontr,, '
-• •rson work to be pe onu
permit as are licensed by M •ami Shores \ illage.
(Signed)._ 's
Remarks.. _____. _ _
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .'p-
peared
to me well known,
and who, being by me first d.dy sworn, upon oath depoPes and says that he is the _ -- _ - - -- -- - -- --- ---- -- - - - - - -- -- --
of th abov. de.c.ibed ;rstruction. t + .:t h. has careially read the foregoing application, and that he did sign the sane, and that all facts
therein by him stated are true.
Permit No Date__ __q® ( ®' -- Read, Sworn to and Subscribed before me.
Disapproved D • te_ Notary Public State of Florida
(Signed)
Bull Inspector -
My Com:nission Expires
-
_DATE
Chairman Member
Member ____
Member
_ _ _ __
Member _ _
Member __. "•
- - -- - - Date
Council Approved _Date Disapproved
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has bet n obtained from
A re- inspection fee of $1.00 will be charged when such re- inspection is mc le necessary by improper notice for insprthe Ph]nr'ng Board
�•tmn or a ity
materials and /or workmanship.
4
11
fi