405 NE 99 St (16)MIAMI S14ORES VILLAGE
BUILDING DEPARTMENT-
305- 795 -2204
Building Inspection Request
Date 9 Time /
Type Insp'n
Permit No. 7 /� ,
Name Pa 1?4
Address
Company
For Inspector /� Name & ate J�r
Vit
Approved
Correction ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
�
Building Inspection Request
Date 1S ^/Q — O / Time
Type Insp'n ` r
�f \
Permit No. T 9 e 1; " -°
Name
Address
Company
f ru- /e k d de
For Inspector: $'la -O / Name & Date
� � 2 / /t-ozeic
Approved
Correction
Re- Insp'n ree ❑
P+7?-6'fftilie
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MECH
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA °�'
Date y
PERMIT
' « red )1e r =' 7
,; 1` pV 11 BI ?' Fri
v5 iY, 9c 5
4946
Contractor's
License No.
9
Work to be performed under this Permit ;1 a,Bd X4047 $ L7rfl 7/
f
PI 10� ! rL ijS . pen t /
s r 491f I Y'o g i (4‘).11P P 641
Sub sto n i � D iV
P 3 2o( 7- 3
Sq. Ft.:
Value of
Project $ ���
Permit:
CCF:
Notary:
Bond:
Radon:
AmountAt
Permitil
3 ow-
F mO
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 applica-
tion 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 or in the statements or specifications and that he assumes respon-
sibility for work done by his agentsrvants.employe�.,
s , , v , / Sig : .- (INSPECTOR) BY
+._.r+. -... �_
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation.
pertaining thereto and in stric` conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I siume responsibility for all work done by either, myself, my agent, servant or employee.
0726A200 07 /19 /O1TOTL 366.80
CONTRACTOR or(BUILDER BY AUTHORITY
t
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 0 -Q Job Address Tax Folio 3( 0 0 ) D ¶ D
Legal De'scnptio `P v' /z' /? 41 4 1 4-et. - historically Designated: Yes No p
/ Tenant ��,/� / 4/' /
Owner's Address "We Phone
Contracting Co (' .; Address 2' 9/,- fe‘ ���,9/:-"
e0 7dts' zz9s'CS Y
Qualifier A 9. ,f1/e/, j /I/ Phone TS7�$7'76'S
Municipal # / / -z iSePp1Competency #0V0/7,55,5? Ins. Co. ,,,j/
Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): .DING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /GMs- 4, 1 7� #1 c am ,
�e
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 perfonned to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBIN , SIGNS, POOLS, ROOFING and MECHANICAL WORK.
5
ctio
e of owner and/or Condo President
0
cons
otary as to Owner and/or C
My Commission Expires:
FEES: PERMIT l0 U -
APPROVED:
Zoning
RADON
Date
Estimated Cost (value)
No y1s to Co
y Commission
Master Permit # ? 9 b �p
AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with al plicable laws regulating
oning. Fucker m I autharize the above -named contractor to do the work state
�tuye Qf Contractor or
xpires: GLADYS l VU.IAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY CO 15610N EXP. MAR. 1 •� °�
C.C.F. q eO NOTARY s` 0 U BOND S o o
TOTAL DUE3f 6 <�
Date
7 — /7-O)
Date
Mechanical Plumbing Structural Engineer
D /
PERMIT NO
ADDRESS:
MIAMI SHORES
BUILDING/ ZON
VILLAGE
NG DEPARTMENT'
SECTION
BY
DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
' PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with aft Federal, State.
Co'mty.Wtage rules end regulations. Wine assumes
no responstbltlty for accurecy oUor resutts from
those plans.
2. This copy of plans must b• iyatltbte on
bi ding site or no Inspection wilt be conducted.
JOB ADDRESS 4 / ® N om / ?9 SY
APPLICANT
PHONE #
APPLICATION (#
SHEET OF
MISCELLANEOUS
DATE COMMENTS INITIALS
CRITIQUE SHEET