622 NE 98 St (7)Name and address of licensed contractor
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the npprovaI of the detailed statement or we 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 n11 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.
Date , 19. ._._
Owner's Name and Address (J No Street _ 6...
Registered Architect and /or Engineer
Location and legal description of lot to be built on: > J 1 C T °
Lot Block � Subdivision
r?
Street and Number where work is to be done . .t� 2 _ .I.IS_. _
State work to be done and purpose of building (by floors)
x 7
(../ Tim /
_.._. and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $. / -.- � 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 the plans and specifications for said building. All notices with reference to the budding and its construction may
be sent to . S
Tae undrrigr applic:mt for this building permit does hereby certify that he understands and accepts his obligations ns an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
anti has complied \kith 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 arc 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.
Date
Remarks — Ce
(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, s,nd that all facts
therein by him s p+
stated are true. �
Permit No n' V Date 4 ) I � Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Buil. ing Inspector My Commission Expires
PLANNING BOARD DATE
Cicair ;man Member
Member Mcmbcr
Member ... Member ...__ _..__._..
Council Approved Date Disapproved Date
NOTE: A ch.mrgc of $1.00 will be made for making corrections or changes to this application niter approval has been obtained (min
the 1'Lennir,;; 1;u.mrd.
A re rrm'pct tion fee of 91.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anu /or workmanship.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the nppro\al of the detailed statement ui ine plans and specifications herewith submitted for the build •
ine or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and nll provisions of the. Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the iuilding Division of Miami Shores Village shall be complied with, whcther 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 . ... 4„//3--)--) M vS
Zone cubage required
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
Registered Architect and /or Engineer.. ...... ....... „1171,,.,...,,,
Name and address of licensed contractor Z��' -S a ••"`/ .7 eD.........
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) f 1 l t;' i 9 / ^-' ge 722 - c.m ._— ...— ........_ -_ .....
S7
and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation y . Roof Covering
Estimate Total cost of improvements O.L7 Amount of Permit S..gOP
.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 undersi applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the Honda Workmen's Compensation Act, being Section 59G6, Compiled General Laws of Florida, Permanent Supplement,
and has complied s‘ith 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 •rk to • •. rformed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
\T ars `E r a''0"767 c)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notaty public, duly authorizcd 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 fads
therein by him stated are true
_..
Permit No.. 9 Date ..... ®./. . ' Read, Sworn to and Subscribed before me.
(Signed) V
Disapproved.. ....( ). r ... Date .._..
Notary Public, State of Florida
My Commission Expires _...._..._.._.__
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. .. Member _.._.....
Council Approved Date Disapproved Date
NOTE: A charge of S1.00 will be made for making corrections or changes to this application niter approval has been obtained from
the Plannir.;; l:u.ird.
A rc•m.pection ice of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials and /or workmanship.
Date'
Legal Description l
Histo Designated: Yes
//)( Master Permit # 37 U q g
Owner/Lessee / Tenant
Owner's Address
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Square Ft.
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
4/41 1.540 40
WORK 1 ESCRIPTION 4 1 - --
Job Address 6.2.z ( p/6 Tax Folio
-)_t()L_o
WARNING TO OWNER: YO
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
law - gulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature •` owner and/or Condo Pre
PERMIT APPLICATION FO
f
tary as to Owner and/or Condo President
MY` s�6 ;• = Ti NOTARY SEAL
s i SANDRA RA k�}ONTIEL
w COMMISSION NURSER
n 4 T Q CC401261
OF FC AUG. 17 1998
r y
FEES: PERMIT ) 7. f RADON
6/
Date
Date
MIAMI SHORES VILLAGE
Address
Phone
Estimated Cost (value)
APPROVED:
Zoning Building
Mechanical Plumbing'
Signature of Contractor or Owner- Builder
No
y
Date
/r A
C.C.F.
Notary as to Contractor or Owner- Builder
My Commission Expires:
Electrical
Date
NOTARY S TOTAL DUE y3
Engineering