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248 NE 98 St (4)nspection Nur Inspection Date: 05/22/2006 Inspector: Grande, Claudio Owner: CHUMBLEY, NICHOLAS AND i+nIIDTM V Job Address: 248 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME OWNER Buildinct Department Comments Thursday, May 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number (305)754 -8278 Parcel Number 1132060134180 Lot: Page 1 of 2 Passed Inspector Co ents (T }, Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Nur Inspection Date: 05/22/2006 Inspector: Grande, Claudio Owner: CHUMBLEY, NICHOLAS AND i+nIIDTM V Job Address: 248 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME OWNER Buildinct Department Comments Thursday, May 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number (305)754 -8278 Parcel Number 1132060134180 Lot: Page 1 of 2 Date 04/21/2006 Permit Receipt Permit Number: PT -4 -06 -978 Invoice Number: PT -4 -06 -24497 Applicant: NICHOLAS AND COURTNEY CHUMBLEY Company Name: Payment Type CheckNum Check CC /AMX Amount $67.30 Total Payment: $67.30 Friday, April 21, 2006 Page 1 of 1 FOLIO / PARCEL # Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Describe Work: Structural Review. $ 4-!1*)C BUILDING PERMIT APPLICATION FBC 2004 Miami Shores Village Building Department Is Building Historically Designated YES NO Type of Work: ['Addition Eteration New 1 L. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. C T 1 S S Permit Type (circle): (Buildi g 5 ElectriEal um ng Mechanical Roofing Owner's Name (Fe Sim 1e Titleholder), ` « ��„ ,� $$ � , / Phone # �M.VOY O er's Address J - lE cx S • Ci l■C C 1( State J' L Zip " ( 3Y Tenant/Lessee Name Phone # Job Address (where the work is being done) l U I )L 5-t City Miami Shores Village County Miami -Dade Zip (-.,?) Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Square / Linear Footage Of Work: ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ `G ` � _ CCF $ C _ � '- -'� J CO /CC Notary $ Training/Education Fee $ 2 L.. _% Technology Fee $ i Z —! Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Total Fee Now Due $ (---,71 . (3L APR 2 1 P i c. A ID aster Permit No. Phone # Phone # -3? gMsr- ID Repair/Replace ❑ Demolition See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Signatu NOTARY PUBLIC: Sign: Print: My Commission E (Revised 02/08/06) APPLICATION APPROVED BY: State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. As identification and who did take an oath. Zip Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 14 �� - �� The foregoing instrument was acknowledged before me this day of, , 20OC;:b e. L-t'7U edlay , 20 , by who is personally known to me or who has produced 1 who is personally known to me or who has produced OTARY PUBLIC•STA`I OF FLORIDA 4 j emande1 Sign: 764 NOTARY PUBLIC: as identification and who did take an oath. 2009 Print: o ,. g Bonded My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Plans Examiner Engineer Zoning Date 1csi . 1 .1% °.■ eanglit City 11 tit 4Laite State � _ �p a' Owner's Name Owner's Address Job Address (where the work is being done) City Is Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Ca Soffit Roof Flower bins - ---- Shutters Awnings a Chimney " Doors and door jams Garage doors Railings Fences Signature Miam Shores Village Paint Color Approval and Agreement Miami Shores Village UB 11�c�g F. County Miami -Da � - 1 1 Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features --"— Accessory Buildings Other APPLICATION APPROVED BY: Owner or Agent 2 P& Z Official Phone # WS 2B fairway saki OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable law regulating construction and zoning. Date Date vrrnn r umocrs 11175 chc 6/18/03 Issue Date: 4/17/2006 Owner's Name: NICHOLAS AND COURTNEY CHUMBLEY Permit Type: Paint Work Classification: New Job Address: 248 98 Street NE Comments: EXTERIOR PAINTING Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 10/14/2006 Contractor(s) Phone Primary Contractor HOME OWNER Yes Type of Work: Exterior Color: FAIRWAY OAKS AND ALABASTER Additional Info: Classification: Residential 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 accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PT -4 -06 -978 Phone: (305)754 -8278 1132060134180 Lot: PB: Total Square Feet: 1800 Total Valuation: $ 600.00 Required Inspections Final Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $60.00 $1.50 $67.30 Invoice Number PT - 4 - 06 - 24497 Total: Amt Due $67.30 CQ MkiY APR 2 1 PAID Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Location and lef al d scrip ion of lot to be built on: Lot Block 3 Street and Number where work is to be done 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 �o bey t" 4 4e // I Registered Architect and/or Engineer ✓ / \ t % L [ Name and address of licensed contractor e M! /r t 77 �— ), t q /r/C 98 SP n State work to be done and purpose of building (b rr floors). state exterior colors (submit samples) C/��'1 / SQ�I /i' O 7 Seats e-�r,,; ° / ° �e,�- SvL l J (S /q7e vA�, / l/(//�i IT L" ��+ 1 � A ' � •v _ 5 1 1 ONO- C) f r no other purpose. and o o o p p New Building Remodeling Addition Repairs No. of Stories To be constructed of - Kind of foundation 3 Roof Covering Estimated Total cost of improvements S �/ 1 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 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. } ss. Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared 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 foregoin application. and that he did sign the same, and that all facts therein by him stated are true. Permit No. 7 1 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 525.00 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 and or workmanship. ivision aLt / a Date / 1 / /5 /U 7 19 U 7 Z' No. 1 Street / ✓ 1 ^ ` C I (G14.iv/er1 ) Notary Public, State of Florida //r/88 4 Yf • Mr. Francis Lubien Building and Zoning Director Miami Shores Village Hall 10050 N.E. 2nd Avenue Miami Shores, FL 33138 Dear Mr. Lubien, As a result of our telephone conversation on January 5th regarding your insistence that I alter the predominant color of my house, from the current slate gray to a lighter color, I am enclosing a sample of an alternate color (22.wtteer.) for your evaluation. This sample of paint is on the enclosed i d?i ex card which I have signed and dated. I would appreciate it if you would tell me, in writing, whether this color is acceptable under village regulations, and whether it is acceptable when applied on the walls of my house. I request that you examine the west - facing wall of my house, for a portion of it will be painted by the time you have received this letter. If the lighter paint as applied to this wall is acceptable, I would request that you leave a signed and dated note to that effect at my house. 248 N.E. 98 St. Miami Shores, FL 33138 January 6, 1988 Mr. Francis Lubien 3uilding and Zoning Director Miami Shores Village Hall 10050 E.E. 2nd Avenue Miami Shores, FL 33138 Dear ir. Lubien, 248 E.E. 98 St. Xiami Shores, FL 33138 January 6, 1988 As a result of our telephone conversation on January 5th regarding your insistence that 1 alter the predominant color of my house, from the current slate gray to a lighter color, I an enclosing a sample of an alternate cclor (pewter) for your evaluation. This sample of paint is on the encicsed index card which 1 have signed and dated. I would appreciate it if you would tell EB, in writing, whether this color is acceptable under village regulations, and whether it is acceptable when applied on the walls of my house. I request that you examine the west- facing wall of my house, for a portion of it will be painted by the time you have received this letter. If the lighter paint as applied to this wall is acceptable, I would request that you leave a signed and dated note to that effect at my house. At this time I would like to state that this application of a lighter shade (pewter) is being done only in response to your threat of legal action should I not comply. if you believe this statement to be in any way incorrect, I would request that you state so on the above- mentioned notice of approval, and clairify your position. Otherwise, will assume that you agree with this statement. will await your note of approval, for it would waste a considerable amount of ny time to extensively apply this 'lighter shade until it is authorized. Sincerely, _ /fr Robert Kitchell, Jr. Robert iqitchell, Jr. 248 N.E. 98 St. Miami Shores, FL 33138 , u rc:aC.5 ancl Wr000:7 Miami Shores Village Hall 10050 N.E. 2nd Avenue Miami Shores, FL 33138 4 BUILDING .s ELECTRICAL r, ' ; 1J PLUMBING \ Owner of Building Architect Contractor or Bi ilder Contractor's License No. Work to be performed under this Permit , • /4, CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE -J J 194 PERMIT N2 5320 Legal -Lot Bi. Description Address of ,' Building -.4 t ,i .;..q , 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 appli- cation 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 . change without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above .. es tIie"t sponsibility� for a thorough knowledge of the oplirtances and regulations pertaining to the work covered hereby whether shown on the plans or jrgs,. : A or n the statements or specifications that he assumes respon- sibility for work done by his agents, servants or employees. ' " — ' °0044-- -, ,_.., r Sign ed. INSPECTOR By ' 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 specificati,ons submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. Subdi- vision Value of Project BY Amt. of . Permit � — AUTHORITY =infractor Builder ;,scription _GILDING _ECTRICAL _UMBING vner g of Lot • MIAMI SHORES VILLAGE, FLORIDA DATE Contractor's No Its_ 2. PERMIT N° 5320 chitect Bl. dress of jam" �t Value of Amt. of _ending t . i G ' �> ` ' , Project Permit j { s. 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 won herefor in strict compliance with all ordinances pertaining thereto and with the undetetanding that the work will be performed `°-- :ins, dra statements or specifications that may have been submitted to and approved by the . s . municipal authorities. This any time the wprk $4 not done in compliance with such ordinances or if the plans p a Lion. A further wit is granted is the understanding that the contractor or builder named above a thorou -Illations pertaining to the work coeered hereby whether shown on the plans s csat =lity for work done by his agents, servants or employees. - In consideration of the issuance to me of this permit I agree to perform the Work ebv Signed - -_ - ' By in compliance with ail 't aining thereto and in strict conformity with the plans, drawings, statements or specificati/l a submitted to the proper author**, accepting is permit I assume responsibility for all work done by either myself, my agent, servant or employee. i 7 CONTRACTOR OR * 1LDER Date Legal Description Owner/Lessee / Tenant C.. Kz ! 0,c /- /21.e/ Y Owner's Address 5-ow X - 7333 Contracting Co. (I,/ �j`d°L" ��''c.__ Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Notary as to Owner and/or Condo President Date My Commission Expires: LEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ( 1 - � � . Job Address (2 57- Tax Folio 2/p / d , 9r 37 2 UrY /OE t UJ - a 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 compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. 6 �� .� S / // r 17) /� gnature of owner and/or C oesident ate Si ature of Contractor or Owner- Bui1'der O r - = - RADON Plumbing C.C. Historically Designated: Yes No Master Permit # �e r� Phone - 13 7' 3/ Vr NOTARY ;V L 0.Y A p FFCIAL MO A My O �tIP11 SSI 1 raRA M YONTIEL 2 14^ » COMMISALION NUMBER .:1 r , CC401 ?61 4' MY CifiNAWISSION EXP. F OF F■..O AUG. r +998 TOTAL DUE (/) / Date APPROVED: Zoning Buil Electrical Mechanical Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE /a oO Job Address r2lig WE 9? #r"- • Tax Folio it cz ,ji W kit- T3 mot & , TS 6I.s/ Legal Description Historically Designated: Yes No X Date ��5wn ..essee / Tenant 74v✓ -h Niu E CAD t°uiE �Z Owner's Address a 8 N E 9 8'` . Master Permit # 1- 7 / / Phone .3 a5`- TS/ - S?? / Qualifier COLS Phone State # Municipal # Architect/Engineer OL Bonding Company 1/A ()Se, 323 Mortgagor Address 1 Contracting Co. W N en., Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION F Clint V EX 'iµ.D 2. ! _ — ab 6 yam 2 yee4 �--- 3 cZ 3 o- � �q,(�t ) G......Q 1��i,� � .�-�n (Pa -i a �3ad�. ., , h) 17400) e) 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. OWNERS 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 owner and/or Condo President Date Notary as to Owner and/or Condo President Date Notary as to Co My Commission Expires: My Commission Expires: ra 57) FEES: PERMIT � APPROVED: Zoning Mechanical RADON C.C.F. 7 - 'AV" ae)c) gnature of Contractor or Owner- Builder Date ntra or Owner - Builder � I Pt0 N71 /- V /S 001972Ti T/ : s Q F i . .; .:;.: ,:iON EXPIRES 6 e OF ._ r�'� .�..__� � . ;; 1/.7002 F� NOTARY 5 . BOND (_>)/ladC) Date TOTAL DUE Building P 4 if 6 Electrical Plumbing Structural Engineer Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE A R Job Address I U , C 0 -41C Tax Folio Legal Description Historically Designated: Yes No ,...\--- Owner/Lessee / Tenant .La (1) . b \g*N Master Permit # L f � ` Owner's Address c N ° / 1 S Pn Phone �S -4 5� — "7? 1 7 s G61 Contracting Co. O � k)pY < Address 4:-/ Qualifier SS# State # Municipal # Competency # Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one : BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1 1 )IJ1 "R� I,d - t- To cc.1 ()L),D(t15 VCCF(12"11 otirr; . 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 work will be don construction and zoning. Furthermore, I authorize the above -named contractor to : - �)�i 1� stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: Signa _ of Contractor or Owner - Builder D to Date otary as to Con at r or Owner- Builder Date My Commission txp Phone Ins. Co. ce with all applicable laws regulating OFFICIAL NOTARY SEAL 9 T � A N ER CC797277 7"). QU O MY COMMISSION EXPIRES OF Ft.° DEC. 17,2002 C -3 83 Q FEES: PERMIT RADON C.C.F. NOTARY BOND Building t i Electrical APPROVED: Zoning Mechanical Plumbing Structural Engineer TOTAL DUE PERMIT APPLICATION FOR MIAMI SHORES VILLAGE -- Date 9/7/93 Job Legal Description Owner / Lessee / Tenant Owner's Address ,C WP NZ 9/ 57 Notary as to Owner and /or Condo President My Commission Expires: PEES: PERMIT l Zoning Address Y� w'ers Tax Folio ) (i' 1 `1 L e y/ %r /cis H. /2z e Contracting Co. /a07.,A/ Qualifier SS# - - State 4k Municipal # Architect /Engineer )' !J . Bonding Company Mortgagor 1/A 099 dtk APPROVED: Fire Mechanical Plumbin& f _ Ins.Co. Buildin Address Permit Type(circle one) (BUILDING) ELECTRICAL PLUMBING MECHANICAL WORK DESCRIPTION / ?/'✓i- /t',OOF cf hfol�I F Master Permit 41.V47 Phone 7/ Flo Square Ft. Estimated Cos value Phone ROOFING PAVING FENCE SIGN 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. - z2let >2 7/7. Signature of owner and /or Condo President S gnatur o Contrac 6r'' ner- Builder Date: - te: Y/ /ec j '-- — tar as to Co J Commission E 4 "EPHINECHURCH � ' p y �ssion xp. tt ,•' No. CC197545 RADON C.C.F. C S u NOTARY 3-P5 TOTAL DUE `� �r Other Electrical Engineering