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.