350 NE 101 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / rv dob Address 350 / 'e / T ax Folio // o e2 (! / 5
Legal Description e 7 c� /) 8 74% / Y /
Owner / Lessee / Tenant jj)/ e 7 a d/ e Master Permit #.M4
Owner's Address 50 N6 & / / 67 - 7 Phone ` 756 -L/3O7
Contracting Co. (� ' AOP �� �� Address / c7
Qualifier � / [. � ' �� / ✓ 7 6 - / 9
State # /2//5 M cipal #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING ME ICAL GOOFING PAV G FENCE SIGN
9 � ��/ O7 22 ti
C I ta l ,L2 r r
WORK DESCRIPTION � �.��� � ✓ ��
/990 9o 7io p elf /49/ 12
Square Ft. 02000
Notary as t
My Commissi
** *
APPROVED:
* * *
* *
Mechanical Plumbing
Competency # Ins.Co.
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
b- one in co iance with all applicable laws regulating construction and zoning. Furthermore, I
orize , ame• ffQntra•- o . o do the work stated.
7 70®-
*
FEES: PERMIT J D• 40 RADON C.C.F. 0 NOTARY TOTAL DUE-3/
**
Fire ,,,, Other
Zoning uildin 1( i lkElectrical
Engineering
P E. i3M.i T *
State of Florida
County of Dade
92R451363 1992 NOV 24 10:45
NOTICE OF COMMENCEMENT
THE UNDERSIGNED hereby gives notice that Improvement will be made to certai
real property, and in accordance with Chapter 713, Florida Statutes, the
oilowing Information is provided In' this Notice of Commencement.
1. Description of prope;ty:(iegal description of the property, and street
address If a v a i l a b l e ) ,55111) , (0 r / 3'
mtbw\( 'jam
2. General description of Imp ovement: e roof
w ��
c
3. Owner information: / /e / -J v " `,. , , ‘` .
a. Name and Address:
b. Interest In property: Q0/9 3S0 13E.. YO\ 5 " -�t 3 8
c. Name and address of fee simple titleholder (If other than owner):
4. Contractor: (name and address) d " •
5. Surety: &f/ 1*t C , Name and Address ) q
l /V k 0./_74 j% /V/ /1/ 3/v
b. Amount of bond $ T.7/ 7620.0z)
6. Lender:(Name and address)
7. Persons with the State of Florida designated by Owner upon whom notices
or other documents rr; ' , y be sere rt, as prov I oed by Section 7 1 3 . 1 3 ( 1 ) ( a ) 7 . ,
Florida Statutes:(Namc and adoress)
8 a d i t l n t ,ymse 1 f, Owner designates d-g /C . / of
�7 to receive a copy of the Llenor's Notice as
provided In Secti n 7.13.13(1)(b), Florida Statutes.
9. Expiration date of notice of commenceme -t (the expl atlon date Is 1
year from the date of recording unless dlfferen da a I; specjl,f,l
STATE OF !`ORIBA
COUNTY OF I
I HEREBY CERTIFY that Ula b a SW if ttl0
original filed in this office ott_... / day of
1(/W , a®. S ti
WITNESS my hand and Official Seal.
Clerk Circuit our
TAX FOLIO NO. / / ✓ MI /3 a071, (
ignature of
day of
V_
May Camm I ss I on Expires
199! tJ
)
27/98
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor_____
Location and legal description of lot to be built on:
Street and Number where work is to be done
peared
Chairman
Member
Member .
Council Approved
MEAMI SHORES VILLAGE
SI ..L .DING INSPECTION DEPARTMENT
APPLIff TION FOR BUILDING PERMIT
Application is hereby made for the c 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 be kept at building during progress of the work.
State work to be done and purpose of building (by floors)
'PLANNING BOARD_-
-, •
Date , 19 //'
4_ / , i • No._,,� Street
Lot__ Block Subdivision _
, j.'��, ri /G
/( . /. > / ,
[. — /L /)li
and for no other purpose.
New Building Remodeling ___ Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering._. - -ti _7. _ /,l �y
Estimated Total cost of improvements $ , > 7t'
' < f < Amount of Permit $ r` l
Zone cubage required plan Cubage_ _ -
Distance to next nearest building__. ___._ _ Size of Building Lot C -' / Y
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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. 7 { i„.1 //
Remarks -- -- - - - - -- - — (Signed) - L '�_ - !,— , /�,_'iF'� 7.
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-
__.___ .. to me well know n_,
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. -
Permit No / e 'J — Date - Read orn to and S / ■
(Signed) 6e—> ..scribed before}xf�
Disapproved _. _ _. ___.._ Date _._ -_..
' Notary Public, StatEll, F.lor r i duLii, , ,,;. i. ,,, , ,,-„;,,l-,,:, . PIRES JUN. ,+-,., a., G,,,t
r , , M.(dl$S
1 lI$Y
Building Ins for My Commission Expires__. : �� , ED O RED IfirgES> 4, lgt il
odS
DATE
Member
Member _
Member
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 fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inst , •on or faulty
materials and /or workmanship.