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1201 NE 100 St (13)1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE o I Job Address / / NE Me 51• Tax Folio / 1- 3 ear oO 06 30 ,e Description E 52, j ii ?go 93 Historicall Designated: Yes zoie3z? Phon 3)5 759-7, / V Address /,'a / /F e l� U vC 1L Qualifier Owner/Lessee / Tenant Owner's Address /at AVE ko /1 37 Contracting CoY 01/0411( State # Municipal # WORK DESCRIPTION Square Ft. 1 U Notary as to Owner and/or Condo President My Commission Expires: Building of owner and/or Condo President / Date SS# - Phone Competency # Ins. Co. Architect/Engineerx /ft Jt —iir( )Ei /Address j ¢/ foe 2 AVE , IlLARA 4 Bonding Company + Address I Mortgagor ,v /�i(I ti c1 i�L1 � 436414.6) Address `f 841- DO At L . co, Dv TauLS6l,vl!Ic r1- 3 y2`f', Permit Type (circle one BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVN ENCE SIGN e1n [ra ) / V ^l %vz . .- h S/ I/ 'IA L: r , 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 VIT: I certify that all the foregoing information is accurate and that all wo be do #e pliance with all applicable laws regulating constructio r. d onin:. )1 ore, I authorize the above -named contractor to do the Date Master Permit # Si a o' Contractor or Owner - Builder l(C�h "Lt�lAlll� %IaF.Y6'r�+t as to Contractor or Oa ►er -Build lAriN 1,1�rt My Commission Expires: 0 �L IC '� C ©PLO U t CO2:.ML ,IOI�17�'a c COMM ION �f.XP. P A% 1 2 FEES: PEWIT V / RA DON � I A C.C.F. �' NOTARY BOND APPROVED: 1 I?X ,,e-O °4. Zoning Electrical v " Mechanical �' VC - `�-' J • (f • d ( Plumbing Structural Engineer *I'm Al, l o00 • _ �' No Date TOTAL DUE Date S cc / 44,a del PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /T 4]( /D6 S Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant J e Master Permit # Owner's Address /0 1 /U / /o 5- / Phone 7 G, a- .7 3 9 Contracting Co. �� co !mil 4UA e 4, �f f] // eA'T /I//L � / e ,Address S (S `J . /9D S/ IrN91 1f 3)'17 Qualifier 36JJ IC - - Phone State # Municipal # Competency # LI II I Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION //'%c ) '/ /c A/c s y.54-e,i4 /- IeA1ke aal/ � ) a Ion ,4/c 4.i S XL. #M7 - 4 / /ke(fle.4e Wig) nue/ / / j Square Ft. g._ — 200 Estimated Cost (value)/ 2 3 S 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. Ai4da D- Signature of owner and/or Condo President a Notary as to Owner and/or Condo President Date My Commission Expires: Notary as to Contractor or Owner - Builder My Commission Expires: FEES: PERMIT //7 , / RADON C.C.F. / NOTARY _ f 7 1� Signature of Contractor or Owner- Builder Adlecl Electrical L/- y /°1 7-( qc o777 ate Date BOND TOTAL DUE (Z �• APPROVED: Zoning Building Mechanical �V' . Plumbing Engineering Date ) `•g j 1 F Job Address /a 0 / N L (0 o Sl/'� e f Tax Folio Legal Description // Historically Designated: Yes No Owner/Lessee / Tenant Ia w t° 1 3 71-0 mod is Master Permit # Owner's Address /o/ 0 / N E /Do S' e -i Phone '76 . - Y 3 92 C o n t r a c t i n g Co. 1I O (d4/r / �' l �a 7 / � i � Address s--IS 4 / F /O , yf e 1 M, o r, ,; .13/ Qualifier 0 n /Y 'C 2! Pri an PERMIT APPLICATION FOR MIAMI SHORES VILLAGE State # Municipal # Competency # 61/(° 1 I I I Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBINGfeECHANICAA ROOFING PAVING FENCE SIGN WORK DESCRIPTION gY I. lace (j) - To n C Sy /''l �.v, /0 4 Qid (J) - - 76 "I ( 4 1 9 W \ i 8 t 1-1'e acte , 1161 lCavh riY 616 J n 13 du (74 o (4, - H-e * s Square Ft .9 70 0 Estimated Cost (value) 3 Sip 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 re a !sting construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. S FEES: PERMIT RADON to I' I, 1 101 Notary as t u er and/or Condo President Date My Commission Expires: C • ;: y.,.; , ;;r; ;r ;r 'r..ff' r'� `.' _ ...._ .:, 6 "Fti l ,103. UDA 17 Nal C.C.F. `'76' -t'39L r or Owner- Builder Notary as My Commissi n NOTARY TOTAL DUE a/' /78 Signat or Owner- Builder Date a- 1-2 /FT Date APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering New Building To be constructed of STATE OF FLORIDA, COUNTY OF DADE. Ss. Permit No Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uinde for the approval of the detailed statement ui 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 V 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. Date ..._m 64 ... 0 .ii 7 . L.--) _ , 19. O.vncr's Name and Address .A05- 4..EEQf' Z. ./(7 _... . ... ..... /q f .: treet Registered Architect and /or Engineer..... K. C,L.4e ..., 1 aD / /l .l. , Name and address of licensed contractor R y .1 4:1..1..I.ILC..: Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) Q .. a..... . fie JeS..T.. � l a _.. . /..<S..Ti�n.._.. frit 3 K� 1 f=1YT...4.. 1 - ,;.....�. . % t-c k ...lO..k.. ,lea/• and for no other purpose. Remodeling Kind off foundation Roof Covering Estimated Total cost of improvements $ 42 900 • Q /amount of Permit S.. ba ( 1 6 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 5066, Compiled General Laws of Florida, Permanent Supplement, and has complied ssith 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 pennit, 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 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. ZD 1 1 — Building Inspector Addition Repairs No. of Stories Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Chairman Member \fccr,ber Member 93— 3?` Notary Public, State of Florida My Commission Expires • to me well known, 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 fmm the 1' l:o.crd. A re inspection fee of 51.00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.