866 NE 99 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
MA 3 Tca / 4 .353<o
Date /l7 A T n 7S 0 S. Tax Folio 1 i' .5 Ze d 14 •Z4cZ Legal Descriiption L DI 4 Tab _ �,... i, LAW'S
0 tag 7 - Ifi`i#s
Owner / Lessee / Tenant 3 10501.- P'rAAc,, $ 1210110AILEAVIGIL Master Permit 141K3044
Owner's Address "g: Pk 9' e! S r /PAPA. -S/l 3 Phone 3eur"� 7 5 - 7' 3
� ,
ContractinCo. RE. i //11 IC t A C Address 7 / V 35I 7 S7 11 (I
Qualifier Idr; 44 Agdv-e.h- Phone 0 4Z(D(9"G4' 110 L/ 7
State # Municipal # Competency # Ins.Co.
Architect /Engineer A //NQ- 17' C-H f't4
Bonding Company /t///4!'
Mortgagor C =b e�/J/1//
Condo Presiden
Address PedalorttOrt 4096 / /'fib O
Address
Address
Permit Type(circle one : BUILDING ELECTRICAL PLUMBING GJECHANIC') ROOFING PAVING PENCE SIGN
WORK DESCRIPTION �p�cz e-5)(/6-7-7;‘,/c. ys rc,'i /n� / 575 7A/
ADD //1/-P (,J OviP_5"-- /v 4! 67 /c 12 ,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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance wit all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -name contrac • o . rk stated.
Sign • re of Contractor or Owner- Builder
Da •
No a to.Owner and /or Condo President Notary as to Contractor Owner- Builder
My om ioi� Nlf BOLLEA My Comniss
•U •':fr% MY COMMISSION EXPIRES
` May 21, 1994
* �a„bt ;o DoNDED 1.461 r AHY PUBLIC UNDERVITEM *
**
FEES: PERMI
APPROVED:
Zoning
Mechanical K.
MOOMM<it►N10_1 00411111
RADON C.C.F. 3 ) NOTAR TOTAL DUE
�J
Fire
Building
Plumbing
Other
Electrical
Engineering,
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ DATE 1 t -ci -6
-6 19 ECTRICAL
EL PLUMBING o PERMIT N9 6969
RO NG ❑
Owner of G,
Building c,I c �t ►�_- t _ 1� Zit—.
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
Work to be performed under this Perini
Subdi-
B1 vision _
Signed.
1
BY
�r:
Value of j [ f /� I } I Amount of
Project $ ( r� V V Permit $
Contractor's
License No.
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
plane, 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 agents, servants or employees.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with U ordinance and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities f Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY ABBOT je.411B.
• --
Disapproved _ _ _ _
( Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Applicat,on is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores llag^, F orida, 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 Miam Shores Village shill be complied with whether her. in specified cr not. A copy of approvcd
plans and specifications must be kept at building during progress of the work.
Date_ 7 7 G 1.- , 19._
Owner s Name and Address ICh?, # A.4 a s . ___ ...fg #4..,x__ E./...__6 rz... . ._ ____ No -- " 6 . ___ _ Street__ )4._F- 91. fr..
Registered Architect and/or Engineer _
_ "z 4 -? r _ o ..- ,f 17: ` / 4., (..
Name and address of licensed contractor .3z a . d__ ALIL 4-, 1: k_... .., ,-,.. __c_. 24 .
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done.' i■ b 14 E . 2? 21 :* fl'ece 4.
State work to be done and purpose of building ( by floors)...../.n_s 4-...a._114 a -r F_esi ci _e.. __
3 1 12(q.
- - ------------ S'ilq" Ilict_ ..
.e.._.. -
and for no other purpose.
_
New Building Remodeling Addition__ Repairs No. of Stories
To be constructed of _ Kind of foundation Roof Covering
0..
Estimated Total cost of improvements $ _ _./.ro 0 Amount of Permit $__ e 52
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 building and its construction may
be sent to__
The undersigned applicant for this building permit 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, Permanent Supplement,
and has complied witk the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by hini
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 )..fc g //fa e- ‘... I
STATE OF FLORIDA,
1
COUNTY OF DADE. ss.
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 stated are true.
Permit No. ___ _ _6 cr__(e. 9 Date__ — s' Read, Sworn to and Subscribed before me.
Date _
BUILDING INSPECTION DEPARTMENT
to me well known,
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING 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-inspectimi fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.