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1290 NE 100 St (2)PERMIT APPLICATION FOR MIAMI SHORES'VILLAGE Date t - 4 - 6t ol Job Address (2 IV C (n p Scree -g Folio Legal Description Historically Designated: Yes x � No �1 Owner/Lessee / Tenant '"()\') }'� r-, Q \CLO (\ / (Y S Master Permit # - / yO / t/ Owner's Address Phone C) — / ` ' �n -6,07c (1 Contracting Co. 0 w C1 4 2-c Address Qualifier SS# - _ Phone State # Municipal # Con Architect/Engineer Addy Bonding Company Add Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Signature of owner and/or Condo President Date Z x44'M or 6F H-10 0se t Square Ft. Estimated Cost (value) c..< u 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. Si ature of Cgfitractor or Owner- Builder Date gd .- C--.-+,e._.,,, 6 /". ` ' Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: My E�epkes; � NOTA Y SEAL r L / • , , - a 0 H /pi 6 FEES: PERMIT 7 RADON C.C.F. r �� D FIs, MY COM PIRES OF g. DEC. 17,2002 NOTARY '- a BOND TOTAL DUE APPROVED: qC� Zoning Building + '/// / Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date '7 `1/41 Job Address 1 Q \ 6 alt II,Q StrvQf Tax Folio // &2 if ©&O e Legal Description _ ; /44 Owner / Lessee / Tenant 713 c?_) . Q t'■c. Master Permit # ?a Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: Address Signa Date: Square Ft. Estimated Cost (value ) * t) 0 Phone ota t as to Co My Commission E Phone 5 -Co 'KC) Owner's Address P 0t O po E too SM Contracting Co. �JtelC2 Qualifier eejF - State # Municipal Ol • Architect /Engineer Bonding Company Amelia Blush 085 White Heron 869 i Mortgagor — Aaarcao Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION Lie 4 (. 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. Owner- Builder ** ** * * * * * * * * * * * ,� ®� * FEES: PERMIT✓ / '� RADON C.C.F. � . NOTARY ✓ r TOTAL DUE e.v, APPROVED: Fire Other Zoning Quildin Electrical Mechanical Plumbing Engineering l '''''t . . '' ., • 4 / DATE 1974 19 /f NO. 5064 RECEIVED FROM : �f`re'Je6/ ° soCK Wfi ADDRESS 197/ 14 /sf 6� DOLLARS $ 0 FOR 1f'f .w ACCOUNT CASH CHECK MONEY ORDER AMT. OF AMT. PAID BALANCE DUE ACCOUNT HOW PAID BY PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY l ob Address Legal Description 0Z State # Architect /Engineer Bonding Company Mortgagor Square Ft. froar -goa to Own PERMIT FEE: APPROVED: Zoning / % �/� /op cr echanical g ature of Owner and /or Condo President Date: r No y er and /or Co do President My Commission Expires: ! 6/ (OWNER TO RETAIN COPY) Fire Building Plumbing -Owner / Lessee / Tenant 7 3, & �✓, )j / dli S(.1// Owner's Address /2-?, 7(Zzf / S7 phone 7 - contracting Co. et/2/6/7� Address ual1fier SS# Address Address Address Master Permit # - phone Competency# Ins. Co. ax Folio /) !.Zoe' allAee Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN til RK DESCRIPTION SZO C 1 64 Qs¢ /4/7 / sZ' 6:— Estimated Cost 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. 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 Contractor or Owner - Builder Date: Notary as to Contractor or Owner - Builder My Commission Expires: * * * * * * * * Other Electrical Engineering STATE OF FLORIDA, COUNTY OF DADE. } 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. Date ,19 Owner's Name and Address 9c Street.. d 6'6 Registered Architect and /or Engineer �7 Name and address of licensed contractor 1'4"" _� �S ( t Y y - Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ,�_a�r � �fi (O e- State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind of,,, punda ion Roof Covering r Estimated Total cost of improvements $ / Amount of Permit $ 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 5968, 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 • - work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on w• to be .erformed under this permit, as are licensed by Miami Shores Village. i Remarks (Signed) /1 _.0 11 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 stated are true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) 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.