MECHANICAL PERMITDate 2
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
J o b Address p y 36 NE /0 1 Sr Tax Folio // — 13 — O Y — OO Lo
Legal Description ti t3R- Y P/}it&C Iz ( ‘Z31L
Owner/Lessee / Tenant
Owner's Address
Contracting Co.
MR. Blum
1t-13o I tol S j
mPorZT���j,_m� .P /4/
��-'•�17 , 17 Address
Historically Designated: Yes No V
Master Permit # 39 9 ?/00
Phone
2120 Sw g2. 4v�
Qualifier N-1 t C OE' L (.A � O ss# Phone 2. 676 - q/i r i
State # CA ,C0 Q S6 9 J J Municipal # Ins. Co.
Competency #
Architect/Engineer Address
Address
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN a MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
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. ti
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT / RADON
APPROVED: .
Zoning
Mechanical L /Wi ?
N CUJ /4/c s y T r)
No
My
/0, Zoo
ntractor or Owner - Builder
as to Contractor or Owner- Builder
Co issspn.Expires;; JAL we yaw ad
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Plumbing Engineering
9 4 To S Tb_TR 1~.
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Date
Date
g -14 - 9.r.
C.C.F. NOTARY Sa 0 TOTAL DUE /8 . Y LfD
Building Electrical
Application is hereby made for the approval of the detailed statement or ine plans and specifications herewith submitted for the build
ine 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 . 1r:.(,.0 . : .:
Registered Architect and /or Engineer
`' n address of lice d contactor PQ`.frl -
` °Z Uation/andlcR I dcscri ton of lot to be built on: �✓
Lot Block Subdivision.
Street and Nuutber where work is to be done [ L _ ____. .r.
State work to be done and purpose of building y floors)
STATE OF FLORIDA, ( .
COUNTY OF DADE. ss
Disapproved
(Signed)
APPLICATION FOR BUILDING PERMIT
Building Inspector
3----3Z � 7 � 6
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
1111-
_� , •
._ No.. L. 'f.311... Street. 1 Q 1 �l '
S 3a —c'1 .
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ ciao. ..DC' Amount of Permit $ xV't
Zone cubage required plan Cubage
Distance .to next nearest building Size of Building Lot _ .......... _ ...... .................. _........_
Mfaxiunum 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..
(Signed)
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 she of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only s yy�ntractors, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
c
Remarks
xks
C4 -t,g S -
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 e.. ,t
Permit No..__ 1 _ Date t J Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires _
to me well known,
PLANNING BOARD DATE
.Chairman Member
\icrr,ber Member
\icmbcr Member
Council Approved Date Disapproved Date
NOTE: A charge of 31.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re—inspection fce of 31.00 will be charged when such re-inspection is made necessary by improper notice for inspection or. faulty
materials and /or workmanship.
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MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE 19
PLUMBING ❑ PERMIT N? 9976 9'7 6 License No 'W I
ROOFING ❑
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of r '
Project $ ,'•.
Amt. of
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 application
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 responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
-'1
Owner's Name and Address.d. `i 4 D •
Registered Architect and /or Engineer..._
New Building
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.
Name and address of licensed contractor.._ .0_1. ,F7 ._. _ - - -1__ ._ ..( F_.ici. izerze
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
Remodeling
/ 9' 20 A/ /
State work to be done and purpose of building (by floors) -4.Q _ S &: .L, L_Q_c!.{ a
and for no other purpose.
Date
No. _/
3
Disapproved � Date
(Signed)
uiB lding Inspector My Commission Expires
- 11- i f 1 ,
A /(2
3 0 Street. / ®
2 -S°- 414t /b:;
Addition Repairs No. of Stories
Roof Covering
To be constructed of Kind of foundation
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 5966, Compiled General Laws of Florida, Permanent Su1plement,
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 p he wor such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcp r.cto s, on wo ;if to be rformed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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
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 5'5 7 {° Date � - —
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
� T C-7