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BUILDING PERMITSBUILDING ELECTRICAL PLUMBING ROOFING Owner of MIAMI SHORES VILLAGE, FLORIDA ° PERMIT N9 5774 Contractor s o License No. ❑ Work to be performed under this Permit Building Architect Contractor • or Builder k d ; :•; Legal Lot Description B1 • DATE. tt , • ki 19 r 1 Subdi- vision Address of ^• R Value of I Amount of Building , . i _ i g - `' ' Project $— f " Permit $ ' - 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 agents, servants or employees. Signed' r • , r ..J. -, . INSPECTOR t' In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordiriances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ae cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY A660T i4' Disapproved (Signed) `' `l Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date APPLICATION FOR BUILDING PERMIT " Application is hereby made 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. ad Date , 19 Owner's Name and Address t_ ' &M , Registered Architect and /or Engin �. � �� Name and address of licensed contractor_ !Lff�/ L�(AC/ Location nd legal description of lot to be built on: �,, �° yy� , Block _____L_ Subdivision_. e l_ /___1s ��'JZ� ' tt Street and Number where work is to be done____j Q_ &___ / 61 State work to be done and purpose of building (by floors) 9 - 0 � $ -' £J No._ 11020 Street /02 9 o) ;V )' and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind jof l foundation Roof Covering Estimated Total cost of improvements $_ / - d d Amount of Permit $ aQ < < 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 contract or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for ins ct .n e site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su]/it o s . . work to be .erformed under this permit, as are licensed by Miami Shores Village. Remarks_ ( 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, and that all facts therein by him stated ( are true. Permit No tJ ed (�_ - Date `' Za " Cf Read, Sworn to and Subscribed before me. 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 $L00 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. (di Gkaca AM. . -- d� la' �� _ ev_oo_ A : 4 9 ° I , Q- 13AmiteT 112Z N.E. la► ST. MIkMt c�l —tc>5 5 1BL . 177 4 S MIAMI SHORZS P, 13 .+ 3 R'7 I#Gr. CliA.tpj LI N fir' E,M CE / Back q tra N.E. 1 ®tcr `r j L L w , FT. Cct, s r `ZLO N° 545 Owner, Ageut..eo•T.ex of.a i l Lot Bloc k�,�, Street Address I / ,. CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village,, Fla , ` . �'" /- Subdivision Approved use by occupancy Remarks • This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances ,Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances, Miami Shores Village pertaining o the erection, construction, alteration or remodeling of building or t. r ctures. A BUILDING OWNER'S NAME la HICI MAN ,�,,,PRES NT ADDRESS SEA VIEW HOTEL 9B B a.1 T u4 ','bOUS' rb Av LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) L120 N. E. 101st Street LOT 5 BLf5 177 SUBDIVISION MS Section #8 GENERAL CONTRACTOR )weer ADDRESS - Same PHONE NO. LICENSE NO. BUILDING PERMIT NO. 6007 D ATE 12/17/47 ��// PE RMIT FEE $ 24 BUILDER•S BOND NQ 661 DATE 12/17/47 ZONE R -5 REQUIREMENTS 20,000 CU. FT. PLAN CUBE 24,608 Cu. FT. EST. COST $ 20,000•UO DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: EWS DATE 12/9/47 X NEW CONSTRUCTION TYPE CBS STORIES I 2 ROOF CONSTRUCTION Tile & Gravel Frame:INTERIOR CONSTRUCTION Oak Firs; Porches - tile-terry REPAIRS DESCRIPTION T,i v R.m —ni n Pm—Kit— RariPm —Rath itpstai rG • her1Bni —Rath r3 rmmstai ra -2 PnrnheG ALTERATION DESCRIPTION Attached 2 -Car Garage ADDITION SUBMITTED TO PLANNING BOARD APPROVED . / 7/4 REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. 545 ISSUED 6/28/48 BY JDH TO .Guy Hickman Sea View Hotel BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE ZZ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 2/17/4 EWS E S F 3/11/43JDH $ SEPTIC TANK Scarbbrc 6379 BEAM' LINTELS .4. 8 J JDH SOLAR HEATER RANGE CONN. $ %lif FRAMING 5/2 JDH S S FIXTURES $ INSPECTIONS DATE RE- INSPECT BY RE- INSPECT FINAL ROUGHING 3/6/48 �s T BY E Mc RE- INSPECT BY TEMP. SERVICE CLEAN -UP GAS ROUGHING CONTRACTOR Hanlon P umbg Co PHONE 3-1611 FEE $ 8 .75 8.75 REPAIRS PER IT NO. 6 O DATE 2 1 NE BLDG. X ALTERATION ADDITION SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE FEE TEMPORARY SERVICE $ SEPTIC TANK Scarbbrc 6379 4/6/48 $ 1.00 $ SEWER SOLAR HEATER RANGE CONN. $ GAS MOTORS S S FIXTURES $ INSPECTIONS DATE RE- INSPECT BY RE- INSPECT BY ROUGHING 3/6/48 �s T BY E Mc RE- INSPECT BY TEMP. SERVICE 3 GAS ROUGHING 5/14/48 SEWER H. W. HEATER CONN SEPTIC TANK RANGE CONN. SOLAR HEATER ' FIXTURES 6/25/48 JDH FIXTURES & FINAL 6/26/4 JDH CONTRACTOR Abar Elec Co PHONE 78 - 8937 FEES 1195 PERMIT NO. 6502 DATE 511 4S NEW BLDG. 1 ALTERATION AD DITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS S FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE 3 ROUGHING 5/14/48 JDH ULH H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL 6/26/4 JDH BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE 6/26/48 BY JDH BUILDING ELECTRICAL PLUMBING Owner of Building .MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 6007 Work to be perfo 1 Bl. sibility for work done by his agents, servants or employees. d under this Permit )1,(/ Architect Contractor / or Builder ( Legal Lot 1 " Description •,J Address of j . ,.. // ;� / i' Value of Building L" E Project L This permit is granted to t e contractor or builder named . •ove to construct the bitilaing or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil 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 5trawi : s or in the s . tem • s specifications ai - d - rIi , assumes resppn- t Signed• CT In consideration of the issuance to me of this permit I agree to perform the work covered hereu er in compliance pertaining the to and in strict conformity with the plans, drawings, statements or specifications submitted to the proper In acceptin permit I assume responsibility fpJall work done by either myself, my agent, servant or empl DATE Contractor's License No. t By 1 with all ordinances and regulations authorities of Miami Shores Village. oyee. a AU Oil Ctf Occ 6/28/48 PAID BY a YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER G. Hickman /7 .'. az • 1948 /a. o0 / A,/ i/ J /'. a-6. 77, 711f J li /3 .2/7 • � .... -_ / _ / 9 '' 42-3/-elf — /9 S d 4 TO / 7 V . /3 9,s' / 5/3 0 -6 -s/ /9 ii / .2-• .3/ s / ` , • , - J - S'l - ° - /f / P._`' ° / - / ;S 6? J . /` -..V D« Sc ADDRESS 1120 N.E. 101st St. LEGAL Lot 5, Blk 177 M S #8 RECORD GA BA iU34.+....tt vT4.iltCpz .... .iicvi0.iti...... ... 1. ,...- do hereby deposit with Miami Shores Village, Florida, the sum of ?lS,� 0� , and I agree with said Village that, when such construction shall have been completed by me within the meaning of the ordinances of said Village, I will clear all premises and repair any Village property damaged by me, �.us'' tcf r the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the completion of such conscructi a meaning of such ordinances, the Village may clear ltd repair the same and pay the costs of such clearance and repai • • � • are aforesaid j shall be returned to me. , and retuttf remainder to me; and that, if I shall clear and repair said property imme <iately, as aforesaid, then sai. w UY m� Issued Amount No. Houses t �_��yy� �tf. -��yy� �i !. t� t/. tf. � af. •�1i�D3 f. lf.� "�y'••lf.• �y��tf.•••"••I1icDTu1icpT�;ic•_• "b'•:?�:r N.•� 11.�"y'••1f• •'•• eQio�ii�v�i •'dCOT4�iFepT4�ii�1� igi;�iiI I'ki 4�;i�OZmifc7t14 fii.. t iami =.rhores9llage : T 1. 0 Y 1 D A -. ' •, 19 7 KNOW s EN, BY THES .' PR Address in consideration of the issuance to me by Miami Shores Village, Florida, f a permit or permits to construct or repair a building or buildings at the following ad dresses: /J o /e/ f WITNESS MY HAND and Seal at Miami Shores Village, Florida, this dL• (Seal) INSTRUCTIONS TO BUILDER -- -When above mentioned construction is completed and the .re ses are cleared and repaired take this bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refun . your on in accordance with the above agreement. VILLAGE BUILDING INSPECTOR'S .. PPRO I hereby certify that the construction contemplated undeihis Bond, h. been pleted and that the build'O, thereof has caused the surrounding premises to be cleared and repaired in as good condition :. the ere bef e commenc • • ' struct' .n. Ak- &■ Village Building Inspecto WHEN CLEARED AND REPAIRED BY THE VILLAGE Amount of Bond Cost of clearing and repairs done by Village . Balance due Builder BUILDER'S. BO 4. at I, Cancelled N? 661 M!S ... ' • . P • . Ji ` 1 %1 e re j i t elnite/Y t• t. Met+N 11 J '� I so ' ?A • 'Jl ...• 1 11.} r STATE OF FLORIDA, COUNTY OF DADE. ss. (MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Application is hereb ma. for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing br other structure herein • escribed. 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. Owner's Name and Address__._ '( Registered Architect and /or Engineer Name and address of. licensed contractor LICATION FOR BUILDING PERMIT Location and legal description of lot to be built on: ; • L Lot Block Subdivision �r- Ga_a Street and Number where work is to be done _ • __4 — State work to be done and purpose of building (by floors)__ ___ N "STo R New Building v Remodeling Addition Repairs - ' 6 CO To be constructed of ' • Kind of foundation ,p e .. Estimated Total cost of imp5ov� $ ;�__ 0 _ ___ 42 _____ _Amount of Permit $ Zone cubage required [/�/� �� ® _Plan Cubage '4 4 ® Distance to next nearest building r� . _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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) _ 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 carefull , read the foregoing application, and that he did sign the same, and that all facts therein by him ted are true. Permit No Date Disapproved (Signed) Notary Public, State of Florida M Commission Expires PLANNING BOARD M 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. sc . F - . - 1 ,19 140 street_ T5 Read, Sworn to and Subscribed before me. V-`___ Ce_ and for no other purpose. No. of Stories Roof Covering_ 4 Kb. V 00 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE //� /9.E' /o / Q l f �`' of 3 11 8'. 3r OS d 11 O Date ob Address ax Folio Legal Description 1)\_S 8 + :' V o tti ct $ {� w rically Designated: Yes No NN 7( /9.41-0 Master Permit # 4 ! s Owner/Lessee / Tenant A Owner's Address f ( - / t/ , L= ,of 44 (' r ( i.4. 0r `4 Phone Contracting Co. 914.t) Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN WORK DESCRIPTIONS / /r� /�4 it / lU Square Ft. 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 APP'IDAVIT: 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical RADON k/7— Building Estimated Cost (value) Date Notary as' o Contra • r • My Commission Expire C.C.F. C J NOTARY Electrical '0 uilder FENCE SIGN ture of Contractor or Owner = • , p� ll11dC1AL NOT . L d ANGELA M B R E s KE COMMISSION NUMBER • cn 'pr- a CC786697 • • MY COMMISSION EXPIRES • OF F AO NOV. 15,2002 ate BOND 3 t1 `` O TOTAL DUE 3/, — 0( Plumbing Structural Engineer STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, attached survey, performed by performed on C / 3- ,Y is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. Witness(sign and print) Affiant is SWORN TO AND SUBSCRIBED before me this 2 I day o personally known to me, 17 produced ' Po,„ — . . Of .' . ore ANGELA M BECKER 2 -12 i C COMMIS ION NUMBER a tit Q CC78669 - '7,.. N O r v CO?AMISSION EXPIRES F OF of NOV. 152002 AFFIDAVIT ei\v\ I-s P a tA4 AIR (K1"" (property ocher) C hq 1e_Q Nni (name of surveyor's company) A , does hereby attest that the Witness(sign and print) 1 as Identification. rr� _� COVE NT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREA _ 7Ur S 4.DA , hereinafter referred to as the Owner of the (owner) following described property: Legal description/folioTh Lot Block I f Subdivision S S- c? e V Tax Folio #: 1 1 3ao.S 01 1 o a8 o requests permission to install: Asphalt, concrete, brick pavers [] andscaping [)Other within the public road right of way of I f) 1') e E' 10 f St (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: I. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 'say of SIGNED. SEALED AND DELIVERED in the presence of: Th iami Sh,oreo (/iCC"crc�e 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) -756 -8972 R(UEcu4 n �im _• r'ti �_ . 9245 S. W. 44th Street SURVEY NUMBER 86 -2 -72 I NEWT CERTIFY that the attacked sketch represents a recent survey seeds under Ely direction. and Is Pram and cor- rect to tiro best 'af my knowledge and belief. T>: are no encroach creacb ■fs. UOISTUBD LAID SURVIVOR 1060 . STATI OP FLORIDA CHARLES W. CARR LAND SURVEYOR MIAMI, FLORIDA SURVEY OF LOT 5 BLOCK SUBDIVISION REVTSET) PT AT OF MTAMT ST-IMPS SF.CTTON S According to the Plat Thereof as Recorded In Plat Kook .No. 43 .. At Pogo ': No P.bnc.Records of Dade County. Rerida_ Dennis Pe r:sand pate- June 18th 9 1986 = 1120 N E 101st Stu MTAMT SHORTS L ,Q 77o , 1.Srr7 =7 cam/ o �Se /e ',• / o LOCATED IN: MIAMI SHORES DADE COUNTY FLORIDA. CERTIFIED TO: American Southern Mortgage Corporation American Savings and Loan Association Lawyers Title Insurance Corporation /30 / 7Z The Florida Flood Insurance Rate Map, dated published by the United State Department of housing and Urban Development delineates the herein described land to be within zone This is not a Flood Hazard Zone. A -/4 This is a land survey and was prepared in accordance with and satisfies the minimum technical standards -of Section 472.027 of the Florida Statutes and the rules promulgated thereunder of the FSPLS and of the FLTA. • • • - • ♦. ... :t:7 : \r'•4A\a'. ••[+.^,b l;i LS + \TF: SiS4•�it/ .4'Y >t..rl'f J'�:}: - ,.r Telephone: 221 -3416 1 77 FT.ORT DA 1 Lo7 - .VE? ' /L S o /-ff 20' w,. /a . 09 / x • I 10/.t5-7- 7 5 at Z 3.7 /1.4.9 /A/ 7.5 GO E L• z /•4a Nis iv P2 dV 571'ea.5 IFS i� zo o titP /4.3 v, /3.70 ry 1 • /G•43 E1 ZG -6S PosvE.e . f - TEL Z/ /e5 / ;ILL. - 8'Po✓ �T. 00 ',I v' 7'` V75 / 1/ 07 - - 14 477at/S S EA �G. 1/ 22 TELMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) f Date t-/ - /6- 't'/ Job Address / /Zb hl L /O I c. -c // 3 gr. Tax Folio is � 9 / -' ' //' ' Legal Description �)r4�Mi �irt2Cs - GiECT�o� � •- Pf3 y3�� - NlarK.1 1 Master Permit it 3/40'51 Owner / Les-see—J.—Tenant uT7.l /65esruD Owner's Address ( l Ra G_(C (0/ c-T Phone - 75-g - /z SG Contracting Co. Qualifier State# Competency# Ins.Co. Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Square Ft. 16'6 cY«c, i1gr_ = Er (PPPROX) Estimated Cost 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. PERMIT FEE: APPROVED: Zoning Mechanical ,e/.0 44 Signature of Owner and /or Condo President Date: • [ 44 Z% / No ry as to Owner an /or, o do President /f My Commission Expires: / /&f * Fire Address SS# - - Phone Address Address Address Signature Date: Building / 4%.-,6. of Contractor orI:Owner- Builder. ary,as to Contractor ° Ow er- Builder M Commission Expires: /// / / * * * * * * * Other Electrical Plumbing Engineering 11 111 1 Mil is 1 111 1 1 I 1E11111[1 1 l �� r STATE OF FLORIDA) SS COUNTY OF DADE, ) he desires to buil And further this Deponent says not. AFF IJ) AV IT 1. Signature of Applicant. 2. Signature of Officer administering oath, f the Village of Miami Shores, County of Dade and State of Florida, being duly sworn, doth depose and say: that under the provisions of Section B -368, Sub - section (d), of the Building Code of Miami Shores Village Block / of �j subdivis on; that he is the owner of said property, and will do the work personally, and that he will, at such times as are required by the Zoning and Building Director: - 1. File plans and specifications and obtain approval of Village Planning Board and of the Building Inspector. 2 Apply for and secure a permit. 3. Pay the required fees for license and for permit. 4. Execute the work in accordance with the provisions of the Zoning, Building, and Electrical Codes of Miami Shores Village. 5. Apply for inspections. 6. File with the Building Inspector certificates that provision has been made to carry the necessary Workman's Compensation, Public Liability and Rroperty Damage Insurance. 7. File with the Building Inspector as the job progresses certificates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume tho responsibility of not employing contractors or sub - contractors other than those properly licensed by Miami Shores Village or any part or portion of the work including, but not limited to, general contracting, plumbing, heating, electrical, septic tank, solar system, lathing, tile, torrazo, painting, roofing and shoot metal work or installation. 9. Not sot himself up as a "Contractor". 10. Execute Builder's Bond. 2. on Lot SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY of A. D.,' 19