Loading...
PAVINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 41 i) f "al) Job Address `/ 7S Z/E / '/ S 7 Tax Folio Legal Description ° 1 Historically Designated: Yes No Owner/Lessee / Tenant y /✓.PA) /'l/.cif v Master Permit # Owner's Address /5 ,(/G- s f / e� ,GJi i, S Phone( 3c) 7-S - /S - 2) 0 Contracting Co. tie( 4 )2c-' T• X ec, Address Qualifier � �7 f / 7 ' � g7,76C SS# Phone COS 23S 3 /J S/ State # / Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING' PAVIN FENCE SIGN WORK DESCRIPTIOIN1/4 � f Cam, �S ¢ c1/..0 4, '� 7 c` GLV' v1/4. 07S C‘...c /5J-7 c --- Square Ft. 7 I J 0 0 S F 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 OF 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 wor 'gnature of owner and/or Condo President Notary as to Owner and/or Condo President Date My Commission Expires: APPROVED: Zoning RADON i /yb Building i - 2 - O/ Date C.C.F. Estimated Cost (valuey( 2 g, vd o • ... • s.. GL'AU'is STATE FlpR1DA PUBLIC ST ((714103 Natal COMMISSION NO. MY COMMISSION EXP. a of Contract N• . as to Contractor y Commission Expire NOTARY BOND 3Oo Electrical /2 - f -oa rOer-Builder 2 37 2O 336 ay -o p Date • Mechanical Plumbing Structural Engineer >✓-- Date /- Q / Job Address /r 00 Mc 0/ Sir4E6 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant 7 - - `( (� v k& O Master Permit # bw er's Address 1 f)c . / 0/ A4-4 et L PKo e (N ) 74-c -g-o Contracting Co. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENCE SIGN WORK DESCRIPTION S quare 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 (W 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 constructign nd zonin • g. ermore, I authorize the above -named contractor to do the work stated. 'Date Signature of Contractor or Owner- Builder Date FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Signature of owner and/or Condo President /-.Z - dd0/ Notary as to Owner and/or Condo Presi nt Date Notary as to Contractor or Owner- Builder My Commission Expires: � PV NATAL A. SI,ATTERY' My Commission Expires: COMMISSION #/ CC 672706 EXPIRES SEP 9, 2001 nlf41Al e A, SLAnEey x ; , BONDED THRU -` 1A ATLANTIC BONDING CO., INC. RADON C.C.F. NOTARY BOND Date APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing Structural Engineer COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, .:1 QL M 0 , hereinafter referred to as the Owner of the (owner) following described property: Legal description /folio #: Lot Block Subdivision Tax Folio #: requests permission to install: Thiami SIiore ?L'aQ Asphalt, concrete, brick pavers [ ] Landscaping [ ] Other within the public road right of way of )500 ,i?. /01 / f PI;AL.! L 54-(p_2,c L. 3 313 (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: I. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on th �I`a_ day of ■ 1 P ia NATALIE A. NpTA 11 ? A S1.R11 �° c o o BONDED 7t ^U EXPIRES SEP 9, 2001 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax (305)-756 -8972 FC ATLANTIC ONDING CO., INC. SIGNED, SEALED AND DELIVERED in h e presence o pRtueiuffy � PPRo►4 -cff (owner) JOB ADDRESS l Sao /D( T APPLICANT t PHONE f< APPUCATION ft . SHEET OF MISCELLANEOUS . CRITIQUE SHEET PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBUC WORKS STRUCTURAL BUILDING OFFICIAL DATE ?0/0/A/62 COMMENTS II (0114_ — m-edS be r e - pt^ d.�tC P t ao ,540t.ovi 0 0(41A) 1. Subject to comptlanca with alt Federal. State. Coczity.Yd age rotes and regulations. Wgtage assucaes no rot pansibtitty for accurecy attar results (coca those plans. Z fits copy at plans must be aictl(tbte ca bu84ing site or to Inspection 1 be candcct42 INITIALS BUILDING ❑ ELECTRICAL ❑ PLUMBING I ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Lot Description I I B1 Address of e, Building e,' V CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? I 10002 Work to be performed under this Permit • " Subdi- vision Sq. Ft. Value of Project Date_ Contractor's License No. 19 II Amount of " `:.•''� 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 employees. if Signed• P ; / -1c "Xf t...: (INSPECTOR) BY 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 MIAMI SHORES VILLAGE- BUILDING INSPECTION DEPARTMENT Owner's Name and Address APPLICATION FOR BUILDING PERMIT RegL§tered Architect and /or Engineer... Name and address of licensed contractor 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 / 3 , 19 ‘ No Street-. Y E /a/ 37` 72-- /V t- -.l °1 .5 7 ' N If 0. . Priv / N7 Location and legal description of lot to be built on: Lot__ Block .. _ _____ _ Subdivision Street and Number where work is to be done I o.P 1V,4 ,4 l ®1 // State work to be done and purpose of building (by floors). _ ___ – L� __. S uR /�� C�° 24 ' P P e Se/Y7 Rt ve £. U,.5) 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 $__ — Amount of Permit $ 2 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 foi said building. All notices with reference to the building and its construction may be sent to.... The undersigned applicant for this building permit dot hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Sec :ion 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 such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) 4 Disapproved _ _._ _ __ D. t (Signed) l� Chat'nnan Member Member Council Approved Building I ; v ector 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 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. / Q � Permit No l Q00 Z Date. 5' /6.__�`�' Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires__ PLANNING BOARD__ __ . DATE Member Member Member 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.