1254 NE 100 St (14)1 APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date 3_i 2 - / p Z Address /� q /✓. E / OO P< sj`. Tax Folio ll- 32.0^ aO7 -00 Z
Legal Description Los y r Le lc I ea /- „I-O/\ 5 40y(S Master Permit #
Owner / Lessee / Tenant A it 2-✓
Owner's Address
Permit Type (circle one
)4' NF ioo r< sA
Contracting Co. t t /L / (6.-- �N'p NS Address 2 .0 8 Sy✓ ‘0r
Qualifier 01114 r 7/ olf42./ 1-- m cConile.I SS #I L .c -62 - j'_5 Phone 96
State1 Competency # ( "1(4 jS :z 1 Ins. Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
WORK DESCRIPTION et4.e
Phone
: BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
pCm ,S TES L/ n ieG � s
Square Ft. `Estimated Cost , e� ?,,, ,f2c,
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 Y.UR 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 accura and that all work,
will be done in compliance with all applicable laws regulatin_ con D iction and zoning.
Furthermore, I authorize the above -named contractor to do
Signature of Property
Date:
Notary as to 0 er and /or Condo President Not
My Commission Expires: NOTARY PUBLIC, STATE OF FLORIDA. My
* '* * * MY (*MMISSIor EXPIRES: 4pri1 1, 19954,
BONDED THRU NOTARY PUBLIC O DERWRITEIL5.
1.50
x.,
kk, 47e
Zoning
er or Condo Pres.
Signatu
Date:
PERMIT FEE: APPROVED: Fire Other
f Contractor)or Owner - Builder
/7 i- ?2
,o0g2PAW 1/ Z.A4(
ary as to C. tractor or Owner- Builder
Commission Expires: I PUBgLIC, STAT$,OF FLORI A
* * * ,: COMMIBBION EXPIRES: April 1,'1995.
&NDED THRU NOTARY PUBLIC UNDERWRITERS.
Building Electrical
1 '
Mechanical - J�� bing Engineering
Permit No •
Tax Folio
/1 32os- 0oq -00y0 NOTICE OF COMMENCEMENT
State of Florida �z `
County of $I•eli /� d 7cuk - r e Yc/ re � i y St4'i ,c9/4
The undersigned hereby gives notice that improvements will be made to certain real property, and in accordance
with section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
Legal description of property (include Street Address, if available) )' y t / 00 / , S/
I —o 7- . o�1C / e#0,-, S 40 c-e. S
G -- -3 - oa 0
General desc 'ption of improvements / �- ` �� ✓I
Owner
Address
v , ttit m / t( �e
� 6 /oo / s
Owner's interest in site of the improvement
Fee Simple Title holder (if other than owner)
Name
Address
Contractor
Address
Surety
Address Amount of bond $
Any person making a loan for the construction of the improvements:
Name
Address
Person 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
Address
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.
Expiration date of Notice of Commencement (the expiration �erte 1 year from the date of recording
different date is specified).
THIS SPACE FOR RECORDER'S USE ONLY
4' /G
2 2 2 ‘ 74.
�r�--
C��
FORM AB -278 New 2/91
STA•E R'DA
COON. { - r DA
I HEREBY of the
CERTIFY that this is a tyi copy
—
fl 'face o
day of
oriRi+YI A. D. 19
WiTTNESS my hand and Official Seal.
J
Cleric C t't Court
eY
92R091959 1992 LIAR 13 16 :17
a r ofowner
p r)j / / /f7er
Printed Signature of Owner
Sworn to and subscribed before me this 1
>in
unless
a
day
Printed Notary Signature
My Commission expir , A.
MY COMMISSION EXPIRES: April 1, 1995
BONDED THRU NOTARY PUBLIC UNDBRWRITEr_
; .
ClAR91All !AMR / .6
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._.. El:) w' f PLL
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 t7,..9 4- NS o 0 ST • z IAA. FA Nlt z'S
State work to be done and purpose of building (by floors )..CL' ,— L �l'� C- ea- §A ' Lt 0wt of.
1 To 0
and for no other purpose.
New Building Remodeling _ . Addition Repairs No. of Stories
To be constructed of Kind f foundation Roof Covering
Estimated Total cost of improvements $__.�_�O0 ' Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building. 6 7.7 01 Size of Building Lot 1 x 1 v5?'
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 sue subcontrac crk to lie performed under this
permit, as are licensed by Miami Shores Village. •
Remarks (Signed).__ I
STATE OF FLORIDA,
COUNTY OF DADE. j ss
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
of the above described construction, that he has carefully read the foregoing
therein by him stated are true.
Permit No
Disapproved
(Signed)
/4'7)
Building spector
MIAMI SWORE ILLAGE
BUILDING INSPECTION DE ARTMENT
(LCONS:).CbVe.eF lgkrv(1 2 O () N• €.1'53 I M l (,2, PLR ,
Date._ ,v - 6
Chairnan
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
Date 1 ' �6\
No...a 5' r Street kV ` .2- • 10 c
Read, Sworn to and Subscribed before me.
,19`01
to me well known,
is the
application, and that he did sign the same, and that all facts
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Member
Member
Member
Disapproved Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty