150 NE 100 St (6)Date '3 • .21 • $) Job Address / 5 /V6 /U0 f'7 Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant
Owners Address / So 6 70 0 L (' 7
Contracting Co. p Q Al ec6 #/ I 7/2,_ Address 6/2-‘ //L /E 7 S /~ 6 -.2c
(- 2 Qualifier l/ ( C SS# S.7Phone '/ 9 ,74
State # CI9'P' n 7,6 7 / Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION f Dr;e e°c T C' 4 x/YQ e c zP
s �rc /r V
Square Ft Estimated Cost (value) 9 GCJ
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 : • 'e- - • contractor to do the work stated.
Notary as to Owner and/or Condo President Date
My Commission- Expires: - -
O
•
FEES: PERMIT
3/z1-1g7
wner and/or Codldo President Dat
4y 3% Y/
3fr
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Evel «4 15
RADON
C.C.F.
Signs (Of Con actor or Owner- Builder Date
Master Permit # 1-- // / 6 / 1 -j
Phone 5,S/' /(,4'
r4 % -
1s5otary as to Contractor or Owner - Builder 1 Date
My Commission Expires z ,; s 1 c • h ; ,
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U NOTARY ` C ' BOND
Electrical
d /-97
TOTAL DUE Y Z °Iv
Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
0
CONTRACTOR or BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 9170
Work to be performed
Owner of
Building . ...p,r-
Legal Lox
Description BI
BY
Date
Contractor's
License No.
under this Permit
4
Subdi-
vision
Address of ,� ,�' Sq Ft
Building �" �°f - ' Value of Amount of
Project $ II Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employee
v _f
Signed • r t '!�' " "t �.B' ` NSPECTOR) BY"'""* _ ... ,
In consideration of the issuance to me of this permit I,.agee to ,perform the work covered hereunderjan compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawing, statements or specifications submi ed to the p 6per authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done bY' either, m my agent, serva t'or empl yFe. Y .
AUTHORITY .
BUILDING p MIAMI SHORES VILLAGE, FLORIDA
Date
ELECTRICAL ❑
PLUMBING ❑ PERMIT N9 9142
ROOFING ❑
ilk-
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
F .fr
CONTRACTOR or BUILDER
V
«.., : • k
Work to be performed under this Permit
II BI
.t ts<^n
7..: A.
Contractor's . . �. b ,
License No 1
c
BY AUTHORITY
19 ±
Subdi-
vision
Sq. Ft.
Value of 4 � II Amount of
Project $ II Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that ho assumes respon-
sibility for work done by his agents, servants or employees.
Signed• . (INSPECTOR) BY
In consideration of the issuance to me of this permit I ag a to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, dravviaps, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work clone by either, myself, my agent, servant or employee.
x ;77 k
Application,is hereby made for the approyal 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.
Ovixiir's Name and Address in If ' e:S
Regiftered Architect and/or Engineer Oh f
Name and and address of licensed contractor _ 0 6 4
Location and legal description of lot to be built on:
Lot Block Subdivision
/6Q 1- 4 sff
State work to be done and purpose of building (by floors) E ri 5- CrI _arY1 Cr? Os. Aff
• a.ka d (kc ,„‘. soel Ct./ .. 6; t i 0 - 6. Le.
and for no other purpose.
Remodeling Addition Repairs No. of Stories
Street and Number where work is to be done
(x.r fLg n S aat'CLP A • --
New Building
To be constructed of Kind of foundation Roof Covering
Estimatedjotal cost of improvements $ / Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next :nearest building. N? Size of Building Lot
Maximum live load to be borne by each floor._
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to_
The undersigned applicant for this building permit dots 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, Pennanent 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 such subcontractors, on ork to performed under this
permit, as are licensed by Miami Shores Village.
Remarks_ ( Signed )_ 7/7
STATE OF FLORIDA,
COUNTY OF DADE. 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 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 5
Disapproved Date
L,)
( Signed)
MIAMI Ship S VILLAGE
BUILDING INSPECTION DEPARTMENT
4.
APPLICATION FOR BUILDING PERMIT
Building Inspecto
Date I t
PLA NING BOARD
Date 7 , 19
No / 4)--( - ) Street A< k
- ?
to me well known,
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
90 69 4
. DATE
Chain
nan 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.
. .•