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ROOFINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date /SW Job Address //f/i / Tax Folio Legal Description Historically Designated: Yes CSV Owner/Lessee / Tenant Master Permit # i % 9 7 Owner's Address //f/ /V- /0/i/4 Phone Address / 2 - � f / ' 1 ' Z d 7 � - -Y -fg 4 e 72 ' G24 ,1' /,f f /t/ Contracting Co. ?t',Q/ ?I "4W Qualifier ,f1 State # C 6 1 2 -10v Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING F NCE SIGN G4/ ��2 S , Au - T' o� ',. C "AMy/i/u WORK DESCRIPTION ALLuair Ft. 0211 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 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 / 00 / q? Date My Co c i it COMMISSION / CC 417174 ,•• ;•' (W KS febrility 11.1999 J) FEES: PERMIT 7 Z/ RADON Date C.C.F. NOTARY APPROVED: Zoning Building \ /' 6 7( Electrical Mechanical Plumbing Engineering Signature o Notary ntr My Commission E tor or Owner - Builder C. PAZIENZA . ;h , = MY COMMISSION / CC 417174 ,i = EXPIRES: February 11, 1999 `%;p ' Bonded Thtu War/ Public Underwriters BOND TOTAL DUE a te ate at Date PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Qualifier 3 - 91 Legal Description // /7e gga,i /eD/1/ 0 / Lessee / Tenant L . 1 11Ae(" (,�C�eSS(`�c��Ql� Owner's Address Contracting Co. State gc (o5 ?(oa 7 Architect /Engineer Bonding Company Mortgagor Job Address Permit Type (circle one): ll5I A), e /0/ 6T, YUlz / - j �po r 11')1f -prb C ` .Add ress C 0.fnS i' Cr) CI0 Competency1 Tax Folio %/ ,205/9 D2 /0 Master Permit # .f/59/ Phone ,2s, N, W . 9 S T' r7s -O•;R2 i f R °' V"d- Ins . Co . 0(c-- Address Address Address ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION D4- OIA. trot $ r, ('rxe 3 I 1')-10p o r1 0 h0+ ► Square Ft. 3 1 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. Signature of Owner and /or Date: ).9 - Nota;ry as,,' • Owner -- My Commiss -ion Expir RERMtr FEE: APPR Zoning OVED: Mechanical Condo President and /or $J j dent e s : NOTARY PUBLIC OF NEW JERSEY * M y Commisspkl Expires Ma 6, 1992 * Fire Plumbing Estimated Cost ri goo ,Do • Signature of Contractor or Owner- Builder Date: Other Electrical Engineering Notary as fo Contractor or Owne r uil'der My Commission. k. STATE OF FLORIDA. " * * M OMMISSIO1 EXPIRES1OCT. 10. 19g3� BONDED THRU NOTARY PUBLIC UNDERW RI g` * 4 available) 4 . Contractor: (name and address/_q, S. Surety: a. Name and Address b. Amount of bond' 6. Lender: (name and address) g IJ tar Fub STATE OF FLORIDA COUNTY OF DADE I HEREBY CERTIFY that this Is • .true copy of the orlginat 'Ied in this - Tice on & day of cj s-a , A. Dc 199/ WITNESS my hand and Official Seal. Clerk Circuit Court By P 01 Tax Folio No. 7/ f,205 2O NOTICE OF COMMENCEMENT 918271034 1991 AUG 06 10:55 State, of Florida PreperzAzi bV; iotry'l..oit• Rernoti4 _ :aunty of Dade OLCt /, Jy Ccht"r tTx, e" (F/ c, - 33/ so THE UNDERSIGNED hereby gives notice that improvement will be made to certa real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of the property, and street address if 1 -0+ It -\K \r) Ca p (Ar .CA Ore S SPC. 4+ g ' I C ._ ? pad e Cool4 4„( FICA- _ . General a l de p t io of improvement : rrA) Fla f �h� f�. T �e 200P • • 3. Owner information: II 11 a. Name and, Address:h � ), C , Sucer_sstc Tc(.lSi c. b. Interest in property: c. Name and address of fee simple titleholder (if other than owner): . "- - Ccc n6 ( --- z - n c , / 9.5) For:dc, 33 /..So .2s I 'rV,.w 7. Persons with the State of Florida designated. by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes: (name and address) 9. In addition to himself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of Owner ;worn to,.and subscribed before me this gVL\ day of , 1991. TRACY SWEETEN NOTARY PUBLIC OF NEW JERSEY My Commission Expires: My Commission Expires May 6, 1991 Application is hereby made for tiro approval of the detailed statement or 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 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 cupy of approved plans and specifications must be kept at building during progreu of the work. _I Owner's Name and Address ..... 4 . 5 ` `� P�� ._. No. // S/ Street_....N Registered Architect and /or Engineer ,:,, Name and address of licensed contractor ....... 7 - (157:449 ..1 , 7;4/ Locatio and legal description of lot to be built onn' /1 J _ ' /9 ,,y,� 4/ Lot. ii Block / / . Subdivision1l,,.� Street and Number where work is to be done A/ State work to be done and rp se of building ,(by,floors) e........ - w..t..:... MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT %W III ••• TIT •.T,TT,TTTlTTT•.• Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE NOTE: A •charge of $1.00 will be made for making corrections or changes to this application after approval the Plannir.g Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice materials anu /or workmanship. 5 5") / z and for no other purpose. New Bui!ding Remodeling Addition Repairs No. of Stories To • be constructed of Kind of foundation e.�Roof Covering Estimated Total cost of improvements $ / L — Amount of Permit .. 3 1" " Zone cubage required Plan Cubage Distance to next nearest building. Size of Building Lot \faxiunum 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 dots 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 hips in the work to be performed under this permit; and will post or cause to be posted for ins ection on the site of the work such public notice or noticcs as are required by the Act. The undersigned agrees to employ only such su tractors, on work _ • be perf • ed : er this pcnnit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLOP,IDA, 1 . COUNTY OF DADE. I 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 state .are , �true. . i Permit No.._...._ I-1 Date O Disapproved. f _ " Date. (Signed) Chairman Member Member Member Member .. ... _..__.__..._._..._._ ...._....... Member Council Approved Date Disapproved Date has been obtained frown for inspection or faulty MIAMI SHORES VILLAGE, FLA. N° 5129 JOB 4t. i /A _�.a/ ADDRESS //S / . 5_ Sj INSPECTION e7 P i TIME READY REMARKS. ct 7". - r A / Q DATE / �� '� Village o f Miami Shores JOB ADDRESS INSPECTION TIME READY REMARKS INSPECTOR N? 4645 ,e_e_rG„ mg Px v DATE /6 "' -"g4 :UILDING :LECTRICAL 'LUMBING tiOOFING ?wner of •,.� Auilding ❑ DATE - Z. 195-- 0 PERMIT N° 4505 Contractor's License No. 1 El ❑ Work to be performed under this Permit `.rchitect ;ontractor 'r Builder -egal Lot )escription '..ddress of wilding i i �� a =` 3 ! , ► - ,;. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA 11. Bl -i e Subdi- vision t.4 Value of / ; I Amount of Project $ ! . ;- - I 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 application ,erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough i,nowledge of the ordinances and regulations • ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificasioris and that he assumes responsibility for work one by his agents, servants or employees. fj % ✓ r > t R , ` f Signed. i 1 , _ f »•,-,,.)y. ,,� INSPECTOR ''''•- In consideration of the issuance to me of this permit I agree to perform the work covered here der in compliance with all ordinances and regulations - ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 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. Owner's Name and Address. Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done Q. rJ Street• • State work to be done and purpose of building (by floors) . - - and for no other purpose. New Building Remodeling. Addition Repairs No. of to 'e To be constructed of Kind of foundation RR f Covering Estimated Total cost of improvements $...t s • Amount of Permit $ Geif 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 pennit 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, Pennanent Su dement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employ by him in the work to be performed tinder this permit; and will post or cause to be posted for inspection • the site of the work such p . is notice or notices as are required by the Act. The undersigned agrees to employ only such sub •ntract• , ¢n orjt to be perfo •ed nder this permit, as are licensed by Miami Shores Village. l Remarks. (Signed) - - -- ` - STATE OF FLORIDA, I 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 cad, Sworn to and Subscribed before me. Disapproved Date (Signed) 5 .. ®i Notary Public, State of Florida _ -. ..4 - 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- 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.