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152 NE 101 St (10)W/ PA OR Apj will PLI o va con, PERMIT APPLICATION FOR MIAMI SHORES VILLAGE //�� Job Address A /0 17 ; r • Tax Folio Date Historically Designated: Yes No _ s 1 39 3' 30`�p 5 I Master Permtt s • ce/ Phone _Tef- 7.S-7- 70-1 -7 Legal Description i//--P 6i'/0/9 Owner/Lessee / Tenant C (G D Oltner's Address 15:2 ( 10 / Contracting Co. tyvt Vim' U HE NEEDS TO FILL THE BLOCK CELLS WITH CONCRETE , AND STUCCO THE WALL & PAINT. S � Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Address Architect/Engineer Bonding Company Address Mortgagor Address Permit Type (circle on : • BU 1 DING - LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN 0d WORK DESC ON L - sow 0-1 5 DE it f -A-c- h )oc odic/26 , /7J7), $Tu CC o 141-i/ 49 //,,// 1 / 1 5- • C/ (J Square Ft. Estimated Cost (value' HE MUST INDICATE THIS ON THE APPLICATION , AND IT MUST BE SHOWN ON THE PERMIT. NO DOUBLE FEE OR PENALTY THIS TIME Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PE APPROVED: Zoning Mechanical RADON Address 'E OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR 1PERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER TICE OF COMMENCEMENT.) allation as indicated above, and on the attached addendum (if applicable). I certify that all work struction in this jurisdiction. I understand that separate permits are required for ELECTRICAL WORK. tion is accurate and that all work will be done in compliance with all applicable laws regulating amed contractor to do thework stated. es: GLADYS) VILLAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR 1 002 i iu2 /'.0-oxa-.0 6,Z0 Signs •• f f Contractor or 07 - B • der Date No as to Contracto Commission Exp C.C.F. ‘° NOTARY . BOND (. 2 Date Building "Y Electrical Plumbing Structural Engineer Contracting Co. d1AJ1 'PERMIT APPLICATION FOR MIAMI SHORES VILLAGE / 6/7 /r `6J� 1r fi // � �OG 1 / /rS\ S Job Address Tax Folio Date Legal Description g 1 1/k, 6 / Lessee / Tenantli, 711 Permit # igf7f 1 -? \ Owner's Addresd / o //// et°�l Phon 7 l Address Qualifier SS# - - State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN \I RK DESCRIPTION /- 7 1 ,r � r & /(5C/25 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 Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: * * * * APPROVED: Fire Zoning Building Mechanical Plumbing Phone itr, a4A4 L I`�' �- as to Co My Commission E )" ** FEES: PERMIT 'Ric RADON C.C.F. 4 1b NOTARY 6-119 TOTAL DUE )5 ( *B Other Electrical Engineering o► o' This property described as: Lot 8 and the West of Lot 7, Block 15, AN AMENDED PLAT OF MIAMI SHQRES SECTION NO. 1, according to the Plat thereof, as recorded in Plat Book 10, Page 70 of the Public Records of Dade .Cou1 inoro , J , o e j 1 o . , 4 4 f 7 :7�1,E lo zoo' NOTE :.'Underground ..,encroachments, if 'any, not located. t 0 - • 10. qL f �0 FL. Reg. Surveyor FL. Reg. Engineer 4,") lei. jb �Q lil Lo r PROPERTY OF . ;•Merc,ur. , ; ;ardle and .T'heodpra NOT VALID - UNLESS A' BOUNDARY SURVEY r► EMBOSSED 'WITH. I HEREBY CERTIFY that the survey ec I s.P represented hereon meets the mini - SUR�'LYOR' 5 SEAL . m requirements adopted by the Meet m i n imum t .L.s. and not cha enc.oach F.L. meTnt.As . over• end J . *, there are - nical' •s't8;•idards °GPs. easements appearing on the plat or visible easements oth than , . n � Or L :by the Baarl as choyrn hereon. pf• .L.411d S rVeyori •.pi r,,uariCto .Sec: 4" 7 ' 2. 0 7, i-,F, - a . '3t41.4 f ,t.: No. 2243 No. Certified To: Title Company Of The South, Inc., Mercury, Eardley and Theodora and Carteret Savings Bank, FA., its successors and /or, assigns. FLOOD ZONE: X • 1? 0 ' -1 DATE SCALE I "=20' t9.Zo� . 1.5.2,-11.E. 101st Street, Miami Shores, .Florida. LANNES and GARCIA, INC. ENGINEERS - LAND SURVEYORS - LAND PLANNERS 4080 S.W. 84th Avenue -Suite B Miami, P.O. Box361131 33155 Miami, Florida 33156 "4,8-31-87 "Recertified ", Name Changed and "Certi; d T " Added. 187 -6727 ' 1 5 -9 -90 "Reber`tified ", "Certified To" Revised 90 -3960 �1) DRAWN BY • i �LI'.�.i.�r ;tt)i. f'C 'C7.1'4 DRWG. NO. 183 -1982 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 bc kept at building during progress of the work. Remarks �yc r STATE OF FLORIDA, COUNTY OF DADE. j ss. Disapproved (Signed) Building Inspector L0.17 Owner's Name and Address . ir 9 - " Registered Architect and /or Engineer 9 - Name and address of licensed contractor 3/ 4 Location and legal description of lot to be built on: Lot 4$9 Block 1 5' Subdivision $i 7) S O r e ` Street and Number where work is to be done , p ._.._ ff State work to be done and urpos of building (by floors) « PPS e c _ �e 9 / z7. .. „Z.. ki - �T 0 • i / s _ A/. &' /ri- s7` (Signed).... Date. �'2/ l fl � – / . ......,19..7 L N ° (Soo2 . � Strcet_../ D / s r . . C,...... T.,. ...,,..t,.y«..,...- T}!Tttll �!T - .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 $ 7 2' _ - 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 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 ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfo - -• T under this pennit, as are licensed by Miami Shores Villa 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 stat d are true. Permit No. __. Date Read, Sworn to and Subscribed before me. Date Notary Public, State of Florida mmission Expires to me well known, PLANNING BOARD DATE Chairman Member Mcrnber 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 fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.