253 NE 101 St (9)Date . Job Address ( 4 /,L / (J/ S / Tax Folio
Legal Descrip '. Historically Designated: Yes No
owner/Lessee/Tenant STEvE/U - t S p O P 14C/71n/9,4/ Master Permt # 4
Phone 75/ 3 "97
Owner's Address
Contracting Co. 5 r L F
Qualifier
State #
c2755 /1/E /0/ 5 7
Architect/Engineer
m
Bonding Company 2 2
C
Mortgagor —
Permit Type (circle one): UILDIN a ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Signature of o er and/or Condo President
FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Address
rfi/ /UT A'6 F t7P1)5E
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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating con ction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
,/; I %J/ ..ii,1 i ..,_.,
Notary as to Owner and/or Condo e si : ' Date
My Commission E irep '? P ie OFFICIAL NOTARY SEAL
0. �i BARBARA ANN FUGA2GI
* ; � COMMISSION NU�.'ICm
"i Q CC36 0999
7, 'WP c ° MY COMMISSION E.
FVO FAI�fl, '^, -1
2
RADON C.C.F.
Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
NOTARY s -9 BOND
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
Electrical
PERMIT APPLICATION FOR MUNICIPALITIES OF DADVCOUNTY
(OWNER TO RETAIN COPY)
Job Address 4,1515 NE /0/ 5
Legal Description /A 3
Lessee / Tenant S TEUMAJ Pt IL/#
Owner's Address 5IinE
Contracting Co.
Address
phone
Qualifier SS# - - phone
State# Competency # Ins. Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one) BUILDING PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION 17 542 / 52���y - 1) /D zic° //I�,4
PEer/- 3(7
Square Ft. Estimated Cos
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. 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 a _ ize the above -named contractor to do the work stated.
Signatur 9 f°'Owner and /or Condo President Signature of Contractor or Owner - Builder
Date: 9/ 7Y/ - Date:
,19e;v
N ar9as to Owner and /or Condo President Notary as to Contractor or Owner - Builder
Commi:�sion Expires: 4'/4/9 My Commission Expires:
PERMIT FEE: APPROVED: Fire (6ther
' 14)
ixe/0
Zoning Building
Mechanical Plumbing
Address
Address
Address
Tax Folio // 3,j, /3 // W 7
Master Permit # .5/ / 6
Electrical
Engineering
257- -.'Y97
Owner's Name and Address t/ r/ � T t-- e ,t %r /-7/
Registered Architect andior Engineer
Name and address of licensed contractor
State work to be done and purpose of building by floors), state exterior colors (submit samples)
Le 5 a s E�
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 building 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 9 D
No. ,Z37 St eZ /o/
Location and legal description of lot to be built n:
Lot/ 7 [7 Block . Subdivision 07 ✓ / / J' l // f c /
Street and Number where work is to be done 7_ ! t / tJ / X7
44 /AtT .r)(/ `7
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
timated Total cost of improvements S A O " Amount of Permit S 7 .5
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
r
1`),=12ga d
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
} SS.
Terence to the building and its construction may be sent to
,Ids and accepts his obligatons as an employer of Labor under the Florida Workmen's
W4
hpplement. and has complied with the provisions thereof, and will require similar
performed under this permit; and will post or cause to be posted for inspection
f adersigned agrees to employ only such subcontractors. on be performed
Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
D 7 Date ` l3 AM
Permit No.
Disapproved t Date
•
(Signed) W
Building Inspector
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andior workmanship.
Read. Sworn to and Subscribed before me.
Notary Public. State of Florida
My Commission Expires