487 NE 100 StDate /
Type Insp'n D LL G�C K.J
Permit No. /6 / 000 3- /95
Name (�.�`4)
4497 Address M & • /Do Sr
Company 02o 1J 1
Phone# 78b 2s 3 (lL ?/
f v /.5 - ,. D
Inspection Date
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT !.
305- 795 -2204
Building I spection Request
i d
Re- Insp'n Fee ❑
pligimISµoacs iJL1.40ix
PERMIT APPLICATION FOR MUNICIPALITIES OF DADS COUNTY
(OWNER TO RETAIN COPY)
Job Address L7/ 1) 5 /O 0.5r Tax Folio // ,3 1 7 7
/O i° 7D
Legal Description 1 -- c) 07 3 02 4/ y3 /� 7n 7 Master Permit # Si /7
Owner / Lessee / Tenant
� //�%C�L 6'601 4-14'
. ,k) g 2 O 3 )— phone 75 C.-/ 6 ?d V
Contracting Co. CJ S14z . $) I"t;A)ce Co. Address ■ / /)L J93,S )
Qualifier vy ,. C SS# 2 - a r - 07 7X b phone rr0( 2 / /
l
State# J F /. Competency# (7� /y Ins.Co.
Owner's Address
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft.
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 th{ foregoing information is accurate and that all work
will be done in ppmpliance with all applicable laws regulating construction and zoning.
Furtherm• --„ o ize the above -named contractor to do the work stated.
Signa ure of Owner and /or Condo President
Date:•'; ( ..
My Commission Expire Notary as to Owner a OgY C�g gtO SE�►k �e�99 Notary to •.ntractoh(
M Y COMMISSION UtiD. My Co fission Expires BO DED T CAW
SIC * * BONDED TNU * * * * *
Fire Other kl___);
PERMIT FEE: APPROVED:
Zoning
Mechanical
Building
Plumbing
Estimated Cost kA fee,
Electrical
Engineering
ST. 7.-W te r
4 DO a or F;:-nice
Signature of ontra tor or ow �r- Builder
Date: ,/ o7 D�
RV PUBLIC STATE OF FLORIDA
•
C ,. I IG
N
*
■•••••"".
I
-
LI_ i Li 1_3u
No.
STREET
PART OF LOT
LOT
BLOCK
SUBDIVISION
ROOF
COST OF BUILDING
PERMIT FEE
o
FRONT
DEPTH
HEIGHT
STORIES
TYPE,OE CONeTRUCTION
BUILDING BE USED OR
ROOF
COST OF BUILDING
PERMIT FEE
,f
/ I
:esidence,..
..v +.,..
t* fi
I7e", Tile,Conerete, Stucco
, res, tel
'
/ y
BUILDING PERMIT
•
Dated
Owner of Building
Architect
Contractor or Builder
I /
,19
Miami Shores Village, Florida,
r Pa✓1'�, ��� ti A 4 "" + , ,
,kt t".„
PROPOSED LOCATION
DESCRIPTION OF BUILDING
d 9 t r
To
This permit is issued to Ay , V ; � g <d
the building above described, as per application, and Specifications 'RereCofore filed in office. This permit is g anted upon the express condition
that all facts stated in the application are true an at the construction complies strictly with the plans and specifications submitted, and in accordance
gpf compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of iami Shores Village, and rules and
u lations of the building department of Miami Shores Village. This permit may be revoked at any time upon t violation of any provisions of said
ws, ordinances or rules and regulations, or upon any change in the plans and specifications unauthofized:bythg ` uilding inspector.
-
MIAMI SHORES VILLAGE
OFFICE OF BUILDING INSPECTOR
, 19 = -s
■9 592
BUILDING IINBP
In consideration of the issuance to me of this building permit I hereby agree to do the proposed cc st r,io in $tact conformi ith g application
and plans and specifications thereof heretofore by me submitted, and in compliance with all provision of�l building laws of the S t Florida, all the
building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the bu• tit department of Miami r� Vill
age.
(SEAL)