269 NE 99 St (9)Contracting Co.
Date 6/14/94 Job Address 269 N.E. 99th Street Tax Folio 11- 3206 - 013 -4570
Miami Shores, F1. 33138
Legal Description Lot 20 & 21, Block 33, Miami Shores Section #1, Amended, Plat
Book 10, Page 70 `
Owner / k4 / xntRk ROBERT H. WIGGINS Master Permit # . r7 .7
Owner's Address same as abov Phone (305) 754 -0498
Qualifier not applicable SS# - - Phone
State 1fr Municipal # Competency # Ins.Co.
Architect /Engineer Marc Campbell Address
Bonding Company not applicable Address
Mortgagor not applicable Address
Permit Type(circle one): BUILDING )$ A1( AMMON Alaatatak MINIM 2AVORM retta ANNK
WORK DESCRIPTION
Square Pt. 280.00 Estimated Cost(value) $300.00
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 don compliance wit, all applicable laws regulating construction and zoning. Furthermore, I
autho iz tl above med ..ntractor to do the work stated.
/or Con4ppRrt4;4tt
• Notary Public -State of Florida
My Commission Expires FEB 20, 1997
COMM. ;# CC 254761
*
Signature of owner and /o i•ndo President Signature of Contractor or Owner- Builder
Date:
Notary as to Owner a
My Commission Expire
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
•
not appl icablP /hA Address
Zoning Building
Placing 17' x 17' slab of concrete
FEES: PERMIT nI RADON C.C.F. 0
Fire
* * * * * * * **
Notary as to Contractor or Owner- Builder
My Commission Expires:
NOTARY TOTAL DUE 3 i(O 6
kizoM
Other
Electrical
Mechanical Plumbing Engineering
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 p rogress of the work.
Owner's Name and Address
STATE OF FLORIDA,
COUNTY OF DADE.
}
ss.
1. 7 71-5
i•
.Fiegistereti A and /9r Engint?t?r. * -• -- - _ - -.. =••:: s: ntt :e::::=tezrt•:tnnratn••c--••t•
Q G..,, t' J= h_
Namd and address of licensed emitrtctor
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) a' '''.7 f //v --,',49/' d _ (-ail 4 ____ C—
[ 6 . 7 � -- ,9—- C 3- ` C qcr /r ` ` �
\ , and for no other u
P rPo se.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation it . Roof �C, veering
^ Estimated Total cost of improvements $ ��� Amount of Permit $, L
Zone cubage required _Plan Cubage 3 _ _
o
Distance to next nearest building s 147- 147- Size of Building Lot /o Gtr /b . .i. / I .. �`/
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 5966, 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)
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 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 sta ed are true. ,---
re
Permit No. ( o? Date z (--7j
Disapproved
(Signed)
Building Insp tor
MIAMI SHORES VILLAGE
Date...J..._ /'tom ''�_ � l ........__ 1��•—
_. No.. G. ....... street_& E —7079: Ste-
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
to me well known,
PLANNIN 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.