271 NE 101 St (8)Date
Legal Description
Architect/Engineer
Bonding Company
Mortgagor
Square Ft.
Signature of owner an
y
Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechani
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
b Address c 2 7 / A). • 6 • / b Tax Folio
Owner/Lessee / Tenant 'RC) UL-S6
Owner's Address c7 / / /
Contracting Co. / e v9.
Qualifier t CL (/ ) (71: ei/'2_
State # 64 Gdaa T l �`
• !ir, 4Q PresifBJltARD J. ANTE
�.� ` = MY COMMISSION # CC 484505
I�� ; EXPIRES: September 2,1998
'•.P, f Vic," Bonded Tbru Notary Publc Undo,wlte a
ot -. as to Owner and/or Condo President Date
Municipal #
RADON C.C.F.
Building
Plumbing
Historically Designated: Yes No
Address
ss# atU c --Olo a 7
Competency #
Address
Address
Address
Master Permit # 3 8 5 9 I
Phone
i S / / w. 757
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING nn
WORK DESCRIPTION � D4Z I .3 / V LA''; • unP_A.4, I U N
1) • /(2/Jr/0
Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICI OF COMMENCEMENT AND YOUR FAILURE TO 1)0 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 instillation 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 -namd contractor to do the work stated.
?5q,-c -5�a
Signature
ontractor or Owner- Builder
%ctiarci T. A r ne - ff�
73a a-ate J7. a. . vacpotAt...d.-p
Notary as to Contractor or Owner-Builder Date
My Commission Expires: 5 a r a.ra a: 5r rd v er
r n - JC L 4 45 . 3- 7so -G1-
32/-
NOTARY
Ins. Co.
Electrical
OOFING PAVING FENCE SIGN
Date
OFFICIAL NOTARY SEAL
BARBARA J BAUMGARDNER
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC210880
COMMISSION EXP. UNE 25,1996
6 TOTAL DUE W a
Engineering
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Permit No..
Disapproved
(Signed)
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR
Dat
D te
PLANNING BOARD
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
BUILDING PERMIT
Application is hereby made for the approval of the detailed statLuient ot ore plans and specifications herewith submitted for the build
in or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores V 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 specUied or not. A copy of approved
plans and specifications niust be kept at building during progreu ofj the work.
Date—m- Gl>6 19
ao . J2 str:ZiCi
Owner's Name and Address
Registered Architect and/or Engineer 4
... 7 , 7 .. ;
Name and address of licensed contractor . E Ailti Ds . / A / -Cv fttif
Locatio nd lcges
a dcription of lot to be bui on.
Block .0 Subdivisicnrn .2 ge‹ 04 .- fi ,3 :7 Oe /3 / 7 / Pe LS
Street and Number where work is to be done .z 71/ /1
State work o be done and purpose of building (by floors)
&" . ,CA C,IC//.& 6 .F.. A i r/ RNst i 6 / 54/15 "7 Af.
-I/ - 776 4'. 6 . '*( 1,to ff., ../ i 1 y H and for no other purpose.
Addition Repairs No. of Stories
(Signed)
New Building Remodeling
To be constructcd of Kin4 of foundation
Estimated Total cost of improvements $ Amount of Permit '())
Zone cubage required _Plan Cubage
Distance .to next newest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said buildin . All notices with reference to the building and its construction may
be sent to. /94 4- 6n- /9-
The undersigned applicant for this building permit does her 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 Siltlfleinent,
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 ins ection on the she of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such ors, on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks
Rooi
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 arefully read the foregoing application, and that he:did sign the sanie, and that all facts
therein by him state e true.
to and S bscri
je
Notary Public, State of Florida
My Commission Expires
DATE
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Plannir.g Board.
A re-Inspection fee of 31.00 will be charged when such re-inspection is made necessary by improper notice
materials anti/or workmanship.
to me well known,
My Commission Expires Dec. 1991
Bonded Thru Troy Fain !Insurance loci
t...... ............ Date
has been obtained from
for inspection rx faulty
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building - r
PERMIT N°
Architect
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
B
Work to be performed under this Permit
3869
DATE 19 .
Contractor's
License No.
•
Subdi-
vision
Address of I ; ,,9, ..-_. y Value of c , Amount of
Building . � Project $ . ,r x � [Permit $
This permit is granted to the contractor or builder named above to co struct 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 sp cifications and that he assumes respon-
sibility for work done by his agents, servants or employees. P ^�
r, v ; f
Signed. :'/• ./ ' -•
" •' � � INSPECTOR
In consideration of the issuance to me of this permit I agree to perforth the work covered hereunder in compliance with'all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications s E mitted to proper authorities of Miami Shores Village. In ac•
y
cepting this permit I assume responsi for. all work done by either,,mysel my,,ag t , s 'uttnt "or e ee.
A(// F;; ".� r r ''',' •.i, ' 4. . '' r , i • , / '$ r'' 'p�., 'y ' rte ✓/-
CONTRACTOR OR BUILDER a ;'� r Bi AUTHORITY ABBOT PRINT
MIAMI SHORES VILLAGE
BUILDING INSP
CTION 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 Sta e of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shal 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
Disapproved
(Signed)
Registered Architect. and /or Engineer --yy��
Name and address of licensed contractor.-/1
Location and legal description of lot to be built on:
Lot Block y Sub /�
Street and Number where work is to be done al 7 /�1 �
State work to be done and purpose of building (by floors) .
". �� act
and for no other purpose.
New Building Remodeling A i loon r Repairs No. of Stories
To be constructed of Kin of foundation Roof Covering
Estimated Total cost of improvements $ ° A 1 • °' 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
Bui ?ding Inspector
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, Pennanent Supplement,
and has complied with the rovisions thereof, and will require sin filar compliance from all contra rs or sub - contractors employed by him
in the work to be performed under this permit; and will post or cluse to be posted for inspection the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to e ploy only such s contract on yoprk to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. J ss.
Before me, the undersigned authority, a notary public, duly a
peared
C
Date d -* _ 19 6�
ar-ird
jthorized to administer oaths and take acknowledgments, personally ap-
- 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 state true. _
Permit No 3 S� Date 5 ' ' ' Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan Member
Member Member
Member ._..._._.. Member
Council Approved Dat 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- ittispection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.