131 NE 101 St (13)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No.
Name V'
Address ) - 'Q-Y-�- r —� v1
Company - 6"1-4';‘ - -D,
Phone #
For Inspector:
Approved
Correction
Re- Insp'n Fee
■
I2�1��1�1
`D ) Time
.
Name & Date
Date
r •
4 _ -
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address / 3 1 NE 1 0 / S Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant # men.. " Master Permit #
1(016C NW (oLi 4p0 - 331
Owner's Address
dust- CQM PA-c r D
a6
Square Ft.
Signature of owner and/or Condo President Date
Notary &s to Owner and/or C President
My Commission Expires: t o 109
. �.•oy� Nilda Montalvo
* * My Commission CC906155
4;;. Expires January 30, 2004
FEES: PERMIT 0 --, RADON C.C.F.
Phone 3 S4 `74 ZO
Contracting Co. Tilt- 1=1.00 Q.. &U1R-- Address 21 N fl � (/C / VY 14011 1i
Qualifier 5 L, C Gc,m Q
Phone
4- Rtll.£iLS
State # Municipal # 9° 02- Competency # / Z c l ? 1 Ins. Co. 7/ 1M1 kiltae t.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): ; MIMING ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION NtienS TO
AVVING FENCE SIGN
pal vewry /PA -TI DeC? /Piotoi PON
c o7Uctt C S►) 0 1 -iv L n W Roc.-e_ - NstrA -L(!0 1✓t rt • c
Estimated Cost (value) f v / e 7
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.
ZH I w
rnzrvicduz)
2) 100
Date
Signature of Contractor or Owner - Builder
'Tr nonAr i ern 24 2 -4101)
Notary► as to Contractor or Owner -Bu
lder Date
My Commission Expires: 1 / 60 0 y
s`s% Nilda Montalvo
*W* My Commission CC906155
\„„e ' Expires January 30, 2004
NOTARY BOND
Date
APPROVED: TOTAL DUE
Zoning Building ^Y/ , f Electrical
Mechanical Plumbing Structural Engineer
0/E
FOUND D. H. � �, • B' ASPHALT PAVEMENT 15' ALLEY
SET P. (. P. o d 75. 00'
■'
5 . /.//0 //
c . 8. S. WALL
F. I.P.: /
( NO ID. CAP)
SKETCH OF SURVEY SCALE: 1" =20'
r
7.9
h
0
0 O
30.70'
28.43'
rr 11
rc
L 65'
9.95
/
NE. iOist ST.
19' ASPHALT PAVEMENT
N
7
00 ,ii
., w - 1
4. 68'
/ SroRY C.B.S.
O
o RES /DEic/CE /Y
n I. F.E. = /2.30' in
° 760" 4'
3.20 �o
,
N
0
0).
/o. a'
/A
()
//LI\ 8.00 ; . • -
6,- ro
co
hh
CC
W FOUND REBAR
-J
J
Tr
o
\.s's-
0. 4'
CLEAR
I F. I.P. 1/2'
(NOIO.CAP)
1 I "COncre fs
/iC
C.b. Co /Qty1n
0. 1'
CLEAR
75. 00'
F. I . P. 1/2'
(NO ID. CAP)
O
FOUND D. H. \O.
Cu
SET P. C. P. o
N'LB.J'92
5:1-//g1/
O.8.S. WALL
•
■v
0. 3'
CLEAR
Lci
0. 3'
CLEAR
;7
7.9
SKETCH OF SURVEY SCALE: i" =20'
CC
J
•
0/E
8' ASPHALT PAVEMENT 15' ALLEY
30.70'
28.43'
F. I. P.' /2' r' "cd)ek,
( NO ID. CAP)
75. 00'
0
/ $roRY C8.J.
0 2ES /DE•VCE # /3/
O L. AE. = /2.30' h
'
• aF,E - //,S4.' to
� ° 76D', 4'
3.24 1
L 2. 3 '
a
//
3.65
1
19' ASPHALT PAVEMENT
9.95/
N
/0.0'
8.00' •
CP-
f
F. I. P.1 /2'
[ NO ID. CAP)
/1 r Q
NE. iOist ST.
of
/0. d
co
h
a �0•
W FOUND REBAR
V
/0.
0
0. 4'
CLEAR
/'A
C.B.S. c'o/afi7n
0. 1'
CLEAR
75. 00t,/
F. I. P. 1/2'
NO ID. CAP)