622 NE 98 St (12)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date
k' 1 /4 T 6?-,?-7( /9\ IJob Address ( , rid '" Tax Folio
t.
Legal Description
Owner/Lessee / Tenant
i
Owner's Address Y'be t l i r`'�"� Mfr. 2 t-t 4Uhe q 5 f7 3o f-C
Contracting Co. 614,1-71 ,; r)/
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Z --�'i Z; G'
our' / w-( / I, / „it.e.,.., "RAFP7,c_iz , 4/
Square Ft. .— 1 timated Cost value) / � j IJ�
&Li/ L
WARNING TO 0 y' R: YOU MUS
RESULT IN YOUR PAYING TWICE F
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.
R'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
egulating constructio, and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
)9L/ 4//‘ 1/45
Signaturf of owner and/or Condo /'resident Date Signature of Contractor or Owner- Builder Date
My Commission Expires:
FEES: PERMIT �0( ✓ 11 RADON
Historically Designated: Yes
Master Permit # 3 7177
7
Address
ECORD A NOTICE OF COM /CEMENT • ° ' YOUR FAILURE TE9°'DO SO MAY
IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires:
C.C.F. ' NOTARY
APPROVED:
Zoning Building 4)1fq1
Electrical
Mechanical Plumbing Engineering
No
TOTAL DUE I P il60
MIAMI SHORES VILLAGE HISTORIC PRESERVATION BOARD
APPLICATION FOR A
CERTIFICATE OF APPROPRIATENESS
NAME OF PROPERTY (applicable):
ADDRESS OF PROPERTY'
NAME(S) OF APPLICANT(S):
(NOTE: IF THE APPLICANT IS A PERSON
OTHER THAN THE OWNER(S). EVIDENCE
OF THAT PERSON'S Al rTHoRITY AS AGENT
Nt1. 5E ATTACHF.D TO THE .APPLICATION.)
TELEPHONE OF APPLICANT(S)
ADDRESS OF APPLICANT(S):
(if differ= than &films u(property)
PRESENT USE OF PROPERTY:
CLASSIFICATION OF WORK FOR WHICH CERTIFICATE IS DIFSTR:
(circle thc letter next to thc appropriate classification)
MAINTENANCE OR REPAIR: The act or pmeera of applying measoses oessain ,..„
material of a building or structure and the existing form or vegetative cover of a site. It may incluck '
where necessary. as well as on-going maintenance and repair. Samples of material must be subiniaed cic.5.
B. RESTORATION: The process ist accurately recovering tba Ruin and scads of a property res • • •
a particular period of time by means of the removal of later work ht hv the replaternew (.( . • • •
applications for restoration shall include site plans (i( required by the Building Permit), t
historicalb: justitymg the work, and any addftional ph000s or inform:Wirt tu support the prepos‹ -•.z!
The privets of returning a property to a mass Qf utility through tri- ..•
possible an efficient contemporary use while preserving those portions or features of the proiy,1:,.
historical. architectural and cultural values. All applications for rehabilitation shall include: stir ..•: ,
Pertniij . and any other supplemanary inforniation. such as ctrawmtcs. that will suppon thc propf.
D. DEMOLITION: 'The proms* tsf deer:ling or tearin g down a building IX Anbailre Or pr.; ■ . • - 1 •
removing or defraying an archeological site or a pan therisof. The applicant shall include a report trpir
action should occur. If this action is to occur for reasons of financial hardship. all pertinent fiTLVKW (:-,' lio; tit
Fertaining to the coo of preservation. demolition and newt conerucnon. Arty other material peito .
cncourasod as supplementary information
NEW CONSTRUCTION. Ire process of constructing a builshog ur suucture Mat has • C • •
Appituntits shall include : a sne plan. elevations. flow plan andtor landscape plan.
FORM: NISHPB.COA (adopted 45)
06/02/95 15:45 MSU
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DESCRIPTION OF THE PROPOSED PROJECT (Explain what changes will a made
and how they will lie accomplished - use continuation sheet if necessary - all applications
shall be accompanied by at least one 3" x 5" photograph P
of the property):
N2ki-e) iJ Iea=te
e)
OWLEDGE AND PELLIEFF THAT ALL INFORMATION
FOR BOARD USE ONLY
APPLICATION DATE (date application received by Secretary of the Board):
DECISION OF THE BOARD (circle the appropriate number):
1. APPROVED
2. APPROVED WITH CONDITIONS (set forth conditions below):
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SIGNATURE OF CHAIRMAN. — �=� _ OATS: 4(2,-)