PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / /zir < Job Address / /✓e /a/ sr. Tax Folio
Legal Description Historically Designated: Yes No v
GA / Tenant
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Owner's Address /26 C ,.,e / 0 / S x,
Contracting Co.
/n.
066 4e5
Master Permit #
Address 79/0 6007 3 /�io;Aac�
Queer /9-7 Phone d',' - 12(3
State # Municipal # Competency # Pfr .5 <}P,?5 Ins. Co.
Architect/Engineer
Bonding Company
Mortgagor t(SL.1
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION f - f".e,rs.4c-° /.- e$ 41...-2 / / /W ' ..
Square Ft. 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.
i ature of owner and/or Condo President .....,
,.
_,I _..,___.,
.4..:'ary as to Owner and/or Condo President Date
My Conunission Expires:
FEES: PERMIT
Date
�ESS
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APPROVED:
Zoning
Mechanical Plumbing
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Phone6e r 7- 9y9 z (o) -7.pp- 9
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Signature of Contractor or Owner- Builder
)ef,� /(2 & Qir1M
Notary as to Contractor or Owner -) ui1d
My Commission Expires:
Electrical
Date
/ / /o1P
Date
■ BOND
TOTAL DUE rb • g o
Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address /o��� /L/� L7/ bpb�
1 1 d/k atiaai
Date
Legal ISescrkption
Owner / Lessee / Tenant
x 0,44„:„._
Owner's Address /?-moo ' /!/4 /Z/ - • Phone 7.(7%
Contracting Co. C252?ia.E/4 -�j e. Address ce )/ /{/&_ / `1/ h 2S
Qualifier Phone y'S/.�'� 3 V
State# Competency# Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one • • BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION
Sque
WAR!
DO
INT]
REC1
Appl
on t
star
perm
Address
Address
Address
/ OST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
A PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
WING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
,./OF COMMENCEMENT).
teby made to obtain a permit to do work and installation as indicated above, and
Lddendum (if applicable). I certify that all work will be performed to meet the
laws regulating construction in this jurisdiction. I understand that separate
uired 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.
Notary as to Owner and
My Commission Expires:
* . *
PERMIT FEE: APPROV
372
Estimated Cost
Tax Folio j/M gg' OO/. J
Master Permit #
X c-bwc-e 62-6?„)
s .�, expires Po9 Building ' Electrical
Mechanical Plumbing Engineering
,19(e--4).
. 1 f
• . ure of Contractor or Owner - Builder
Notary as to Contractor or Owner - Builder
My Commission Expires:
(-Other Wzi19)v
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR 1/0511111ING PERMIT
Permit No 4
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 'pacified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address Sv‘..14--AvvAia Street.
Regl /or Engineer
Location and Legal Description Lot-- /
Street and Number where work is to be performed—No
State work to be preformeil and purpose of building (By Floon)
New Building Remodeling Addition
No Street_
Bloplr
6) 6 £, / / st
Size Septic Tank.. of Tank._
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pit
*'*%(
Amount of Permit $ / ( Signed)_
1 4 4'k t ? ‘ r : Inspector
P— _
The undersigned appllcant for this building permit does hereby certify that he =demands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5908, Compiled General 4aws of Fl ennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors lor su . of tractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si .. ..
of th work su6 public or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, to ormed nder, permit, as are
licensed by Miami Shores Village.
Repairs No. of Stories
Capacity Gab.
STATE OF FLORIDA, }
so.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
• ..
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made enecessary by improper notice for inspection, or faulty
materials and/or workmanship.
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MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR 1/0511111ING PERMIT
Permit No 4
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 'pacified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address Sv‘..14--AvvAia Street.
Regl /or Engineer
Location and Legal Description Lot-- /
Street and Number where work is to be performed—No
State work to be preformeil and purpose of building (By Floon)
New Building Remodeling Addition
No Street_
Bloplr
6) 6 £, / / st
Size Septic Tank.. of Tank._
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pit
*'*%(
Amount of Permit $ / ( Signed)_
1 4 4'k t ? ‘ r : Inspector
P— _
The undersigned appllcant for this building permit does hereby certify that he =demands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5908, Compiled General 4aws of Fl ennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors lor su . of tractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si .. ..
of th work su6 public or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, to ormed nder, permit, as are
licensed by Miami Shores Village.
Repairs No. of Stories
Capacity Gab.
STATE OF FLORIDA, }
so.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
• ..
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made enecessary by improper notice for inspection, or faulty
materials and/or workmanship.