34 NE 101 St (10)Legal Description
/ Lessee / Tenant
Contracting Co.
OWNER'S AFFIDAV
be done
aut
** *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date
`' '3° '9' Job Address .24 N E 13 ( r
Owner's Address 3 ( /v t (0(
Cl L.
Qualifier PO eit I CI, e pT Phone 8S 6,1 9 W
State # C # o KgO2.3 Competency # Ins.Co. /nar y (qJ l r1s.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING
WORK DESCRIPTION , ! 0 . I 4 -7.. 3 7 d nJa.¢� .Z a
Ccv�n.: &ka ., ' / i1 - r
Square Ft. Estimated Cost(value) 1 cP c/a 0
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.
and /or Condo � P � r
G 1 -� : S: J. �.iJ'IC�C
MY COMMISSION n cC4389
February 14, 1999
PON F T 471 Tow ..,, ..
•
Notary to Owner and /or Condo President
My Commission Expires: a -- (C1 —C
rtify that all the foregoing information is accurate and that all work will
with all applicable laws regulatin_L onstr ct j;=A =a• zoning. Furthermore, I
amed contractor to do the work stat
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FEES: PERMIT 75 - RADON C.C.F. i NOTARY
APPROVED:
Zoning
Mechanical
#//tr,
Plumbing_
Address
Tax Folio
Master Permit #
- 14'( - 6928
p. o . G0 6 art '3o f ; (.
Phone
ROOFING PAVING FENCE SIGN
Signature o" Contractor or • r -Buil
Date • ; s }'V
PAMELA J. LONG
MY COMMISSION # CC43895
February 14, 1999
1 ' ' t 9" RONI1Ff1 TNRI! TRr1V FAIN MCI IRANPF IMP
Notary as to Contractor or Owner -Bu
My Commission Expires:Q -( -9 j
TOTAL DUE , 4,1
Fire Other
Building Electrical
Engineering
O.vner's Name and Address
Location and legal d escription of lot to be built on:
�l s' �i
Lot ...7 Block
Street and Number where work is to be done
State work to be done and purpose of building (by floors) 7W
741 .14012`.. 4
Building Inspector
Cirair:nan
\fcrr,ber
Member .. _.....--- .._._..._._ .._._.......
Council Approved Date
MIAMI SHO4CS VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR, BUILDING PERMIT
Application is hereby uindc for tic approval of the detailed statement or me 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 be kept at building during progress of the work.
3 At<o
1es_
Registered Architect and /or Engineer ...•••,,,• ,,,.,n, ...,
Name and address of licensed contactor .. Y »L C /0/ y.`S
New Building Remodeling Addition
3 Ill /tie `®1 . S
Joni -
To be constructed of Kind f foundation II A R Covering
Estimate Total cost of improvements $....- Z Amount of Permit $. r
Zone cubage required 444444 � – .._...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, Perrnxnrnt Supplement,
a nti has complied ssith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe by him
in the work to be performed tinder this permit; and will post or cause to be posted for i on the site of,,thZ work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub J R p rs, on worjo. be, performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks..._ __._.__ (Signed).—
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 stated ae true.
Permit No.._..�" 1.) . Date .. � Read, Sworn to and Subscribed before me.
Disapproved � ... \��.. l Date
Notary Public, State of Florida
(Signed) v i WVV
My Commission Expires
._ No.. .. . Street_. Za/ s"T
Subdivision . ,S ..>l...!'
Sv,57t,U 6. ) er
'c7 / 02 0 7
PLANNING BOARD DATE
Date..._..._. 0/ _..._.__........ 19.._._
1�. t2 D 6 / /, 7p a�
and for no other purpose.
Repairs No. of Stories — _
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
to me well known,
Member —
Member ._....._
Member
Disapproved Date
has hecn obtained from
for inspection or faulty