PAINTDate
Legal Description
Owner/Lessee / Tenant
Owner's Address
Contracting Co
Qualifier
State #
1 .
UL14q,
4,4145
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE i�
Job Address 9 �t Tax Folio
Historically Designated: Yes No
Phon(d
Address o D
.*Lo / P4//e/t.
Bonding Company Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING
WORK DESCRIPTION - ' -/ � A:Pit/r
gcx9 t- wh l `re to wk
Signa of owner and/or Condo President Date
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PE
APPROVED:
Zoning
DEBRA J. M(.1CLUNE
s4•, : q MY COMMISSION CC 830214
T.Ifi EXPIRES: Apr 28, 2003
Ir :.. 3 Fla. No :; a I t : COrc irg Co.
Mechanical Plumbing
C.C.F.
Master Permit # 7l
SS # Phone
7
?Da /7p6 Mu # .3 6 #
Architect/Engineer Address
Mortgagor Address
Square Ft. Estimated Cost (value)ig
MECHANICAL ROOFING PAVING FENCE SIGN
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 with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signs ctor or Owner- Builder
-/7- Z/00 p 1/— jih C e/ — i- / V o
Date Notary as to Contractor or Owner - Builder / I3 ate
My Commissio i .i, r
i : DEBRA J. McCLUNE
k MY COMMISSION # CC 830214
NOTARY BOND
005 r6
Ins. Co.
TOTAL DUE
; - / - c'23
�i.
Date
Building /4/7 Electrical
Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date V ` a'7t Job Address C TS' J' E 9Q Tax Folio
Legal Description Historically Designated: Yes No
Owner's Address
Contracting Co. X
/Tenant„ EU2 7J
cis- )e 9i
Square Ft Estimated Cost (value) • / Q 71'�
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON
APPROVED:
Zoning
Mechanical
Signa
Not
My C
C.C.F. ' 6 0 NOTARY
Phone
Address
C
Master Pert #
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION SEAL 1 Ph( nit ( (t Roo F- . -- tz) J°/i-tavr
(4-0sE MOO I6r4 -r c '(0 -3 (3. Gt41. 1'( fN1S
Stencil Blue • 708
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 with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
a '
' Contractor or
SS
as to .n ►'
•
wner- Builder
-30— 70
wive ' NO. CC714143
MY COMMISSION EXP. MAR. 1 "MT..
Electrical
BOND
TOTAL DUE 5
Date
. Ocz)O
g -2‘10-9g
Date
Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
K
CONTRA
Ar tect
Contractor
or Builder `� : ,$. 1 t < r
Legal Lot II Bl.
Description
Address of f ► _" `.
- Building
MIAMI SHORES VILLAGE. FLORIDA\
DATE " J. n
PERMIT N? 10307
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit
1950
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 application
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 resp sfbility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in tho tate.men r specificatio and that he assumes responsibility for work
done by his agents, servants or employees. \
Signed : ' •" 1 t „ ae (,,,�. `\..::.]' r RY
INSPECTOR
In consi . ration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining th . and in strict confo mity with the plans, drawings, stn ents or specifications submitted to the proper authorities of Miami Shores Village.
In apcepting p _ it I 14ponsibility all done by er, .myself, my agent, servant or employee.
AUTHORITY
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby rnade 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 progress of the work.
19 <)%
Date � �
No.°- �)
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
Notary Public, State of Florida
Building Inspector My Commission Expires
Location and legal ��;-}���;
al descri tion of lot to be built on: ' ' E'' 7'' t��. th
g description d � �.
Lot Block Subdivision
and for no other purpose.
New Building Remodeling____ Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
>
Estimated Total cost of improvements $__________ _f Amount of Permit $
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 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 subcon ctors, on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed) 117 L 4. Y___{ 1!" 441 j
STATE OF FLORIDA, , .`
COUNTY OF DADE.
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, and that all facts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
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- inspection 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.