1279 NE 98 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date .2 Job Address/ 79 41E. g T- Tax Folio /I -.3.20S- OO9 - 0 7O
Legal Description l� � !/►� / 7 n i
Owner / Lessee / Tenant D 2 i ■, • i J O / / ? c I S , L v r r p e . a ) f j i 9 A _ Master Permit 4 3,3 2
Owner's Address /a7' ?f? S Phone 7 - .275 0
Contracting Co. 5
0 ,49/ ,9 2,9 "z'i,t)c [ , ,tJ7 Address /O / -z itJ,) ..2 o d1/ /1,i9�[- / ft.
Qualifier _:94/E. - ..6. 6ip e
- Phone 6 9 -.Rion
4
State #O0.6'k,S�f? Municipal #QO /7SS7 Competency #/R 4Ly'342 9 Ins .Co. �t1GGI ATLgn�T /�
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANIC ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ' #4.2,4-/ c; F/BE.. G../...4S5 1 iii/774 ,do7 ,44'"
C / }/.30 77,1)_ ,a5 6i /s a .c. i/,*r15 r /(2)10.6 fral4ss 4.04407.1 /�,'fl .
Square Ft. gin Rg_ f/9T' Estimated Cost(value) /n
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 FINANCI: , 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 with all applicable laws regulating construction and zoning. Furthermore, I
authorize the abov-named contractor to do the work stated.
Signatur- of owner /or Condo President
Date: /10./...26/9?. Nota as Co Ore and
APPROVED:
Zonin
Notary /or Condo President
M' Commission E.itpires:
NOTARY PUBLIC STATE OF FLORIDA
MY COIMISSION EXP SEPT.26,1993
** * * BQNIIED NU GENERAL INS. VND.
Sig
Dat
My Commission Exp res:
'Olfl 'SNI MOOS fl HL O3ONOS
Li6L'9Z'1d3S dX3 HDISSIIWO3 kW
* * * * * YOI N 1A AO 311iS 9 i91W AIIVlON
FEES: PERMIT .ro €ct29 RADON C.C.F. JiJ 0 NOTARY TOTAL DUE 11 O �
Mechanical Plumbing
' ture of
• /a/a6/q.2.
Al
Notary as to Cont actor or Owner- DaiLder
Fire Other
Buildin: iif /� Electrical
Engineerin
or or'Owner? `uilder
•
**
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby uinde 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.
43 squares
Owner's Name and Address Gilbert B. Hollingswwrth,. Jr,
Registered Architect and /or ltinginver ...., VV
Name and address of licensed contractor Lang Roofing es Tile CQ...,....
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 127 N.E. 98th Street _ �
State work to be done and purpose of building (by floors )._Reroof : TQar off .,..acist 1Q.f ng, „ tia Cfsj2
felt to sheathing, mop 1 -901b. slate with hot asphalt and install shin&le tile. j-)
Gravel: tin cap 1 =30# felt, mop 2-15# with hot asphalt and apply layer of gravel. -
an ror no of er purpose.
New Building Remodeling Addition Repairs REROOF No. of Stories 1
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 6 Amount of Permit s.12...5Q
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 Sup element,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub ntractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the si e work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ .` such subcontr • • s, on be performe4 under this
pennit, as are licensed by Miami Shores Village.
Rernarks (Signed)
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. .._ 4 / — Date
Disapproved _ Date
(Signed) ` ''`
Building Inspector
Chairman
Member
Member ...... __._._---- ._..._.�.__._
Council Approved Date
Date... _..._......._....__ _._.._..._ June l./. ,19
... No.. 2,279 ... street.rl.F .... �1$th _tx eet
Read, Sworn to and Subscribed before me.
PLANNING BOARD _.._......DATE
Roof Covering. Tile & Gr.e. e.1..._.. .
Notary Public, State of Florida
My Commission Expires
Member
Member
Member �-- -- ----
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection oer faulty
materials anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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 a' building during progress of the work.
STATE OF FLORIDA,
COUNTY OF DADE.
41
SS.
Building Inspector
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
Date.
Owner's Name and Address..... �.... .. .. ' e '.? ..'.. No 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 /2 � e �• l.. f�i' j
State work to be done and purpose of building (by floors) Verfe.
za4
and for no other purpose.
New Building Remodeling Addition v' Repairs No. of Stories
To be constructed of Kind of foundation R Covering
Estimated Total cost of improvements $ I S Amount of Permit $ 4, 0 0
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 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 .....___.__
PLANNING BOARD DATE
19Lta
( Signed).! / C «�
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._ f tT Date 2 Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty