Loading...
1163 NE 101 St (3)Si • Date// 7/ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE P 8 Job Address / /b-3 /(7Z /D / s% Tax Folio ft 3 2.05 -0220 Legal Description Ms e Pe.), R8 143 -67 1.4 1 Historicall Design Owner/Lessee / Tenant � `7/ jl ' goy Owner's Address /16'3 Contracting Co. M&ai 4/V/ ( ! State # fix) (L 1 0A Municipal # Affellites4Engineer H A. X ,xt Notary as to . My,Comm�ssio , FEES: PERMIT 3 RADON e resident Date r1t lirlet E. FERGIE101Ie My Comm Exp. 09 /15/2001 Bonded By *vice Ins No. CC680537 t l PersanaI y Known I I Other I.D APPROVED: Zoning Mechanical Plumbing ?Building Competency # Ins. Co. Address 12 1 N.W. 33 401C, Phone 3o ( ST0. 20 2'\ Bonding Company Address Mortgagor Address Permij Ty (circle one BU DING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN DES R . v �1w0 leak' ® � d ise G v WORK ORK DES � &'' 9316 / �� ivabei apt ia. 1 ° Square Ft. 37s Estimated Cost (value) Sa 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 constru g and zoning. Furthermore, I authorize the above -n • ed contractor to do the work stated. tractor or • wner -B •a er, C.C.F. , NOTARY tracjg fir-Builder'.. on El leieeary Known 110ma i.D Electrical t'.- ^- .r,r 6 9 6 Date TOTAL DUE Date Engineering t NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. _ - TAX FOLIO NO. � • 3 2 (.3 5 STATE OF FLORIDA: " COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: M lOM. S�S • 1 D Q J. ` a (.7 1-0T•12.• 3LI 174 1 I h3 v■E (or S+ree -k- 1111irr,�•; � 'S �1� 33�3g 2. Description of improvement: At.t_:rvi t� 3. Owner(s) name and address: v , 1"c ��' � S 116 lo b S Interest in property:. S Name and address of fee simple titleholder: ( ,�� 4. Contractor's name andaddddress : 11A A 1 •wTE Or= t COUNTY OF DAVL. 1 HEREBY CERTIFY that this is a t py of the origin filed in this gffice on ( y ird Of icial Seal. LERK, of Circuit and County Co r 5. Surety:(Payment bond required by owner from contractor, if any) U� Name and address: - l Amount of bond $ 6. Lender's name and address: D- M. 7. Persons within 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: r rn • � S (I 23 Nt (Or S e A �1tc✓w1 S ,- reS YsE 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Name and address: I• / A 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) / r &gnat re of ner Prin Own s Name Sworn to and subs• i ' •d Notary Public/26" Print Notary's �l. My Commission Ex ires: tatutes. 0 t % . 0 2.0 98R399590 1998 AUG 13 14.:24 W TRESS my HA; vE r RU Prepared by: 4 ?cit �?AOI Address: 1s tVw tiq 2 44A''4 123.01.52 2/93 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Da g MARCH 28, 1990 19 Owner's Name and Address BERGERON == 756-1316=== 1163 N . E . 101 -MIAMI Street_ SHORES , FLORIDA o. Registered Architect andior Engineer Name and address of licensed contractor SEYMOUR GOTHELF == 591 - 8990 == 17630 N.E. 7 PLACE, NORTH MIAMI BEACH, FLORID Location and legal description of lot to be built on: Lot /Or Block / MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Street and Number where work is to be done 1163 N.E. 101 STREET = =MIAMI SHORES , FLORIDA. State work to be done and purpose of building (by floors), state exterior colors (submit samples) PFPT.ACTN(; R .TAT. WnWS WTTR R ATW TN F.XTSTTNG OPRNTNGS. NO S`PPUCTURAL CHANG1 S_ and for no other purpose New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Thtal cost of improvements $ 1845.00 Amount of Permit S 1.1) 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 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 obligatons as an employ Compensation Act. being Section 5966. Compiled General Laws of Florida. Permanent Supplement, and has complied with the pr compliance from all contractors or sub - contractors employed by him in the work to be performed under th' permit; and will on the site of the work such public notice or notices as are required by the Act. The undersigned agrees • employ only s c 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 appeared S rb-PY1NUcXZ Go - - h21.p and who. being by me first duly sworn, upon oath deposes and says that he is the r h./-6-r `V Q 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 J Permit No. k991 Disapproved Date (Signed) Building Inspector Date s - 0 Subdivision 7112 . ,.. e i (/ em,.. /1 g/Q < /9 a D o� PLANNING BOARD DATE Labor under the Florida Workmen's tsions thereof, and will require similar st or cause to be posted for inspection ubcontractors. on work to be performed /1C s5' /y to me well known. Read. S to and Subscribed before me. Z.vY4l/ r���i1T Notary Public. State of Florida NOTARY VUDLIC STATE OF FLORIDA My Commission Expires av CONMISSEgf Exp JUL 25,1991 CORDED TNRU GENERAL INS. Ul:U. Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Roard A re- inspection fee of $25:00 will be charged when such re- inspection is made necessary' by improper notice for inspection or faulty materials andior workmanship.