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83 NE 100 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address g5 (q , 1 one ST Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant Mr Mrs . G1 r \ Master Permit # 3.7271 Owner's Address '' /.1. ( D O - 1 - ' , Phone 7 5 `7 Contracting Co. 4, N /A -- Address Qualifier SS# State # Municipal # Competency # Architect/Engineer A/ A— Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1 1 l ti rl ill ra Joa rd a V1 -e X` 1 S I 1 extbi woo n -J(At , Square Ft. j 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. 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 -named contractor to do the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date otary as to Contractor or Owner- Builder Date My Commis,sji o E c VvGY s7aL � . Z ��r�((f X�l SANDRA C.L �ONTEM., off .,`, ' -,f, CC ©C L3 EV- .21 9 rl° My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical RADON Building C.C.F. � NOTARY TOTAL DUE Electrical Phone no Ins. Co. or Owner - Builder Date Plumbing Engineering BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of 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 iuilding 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. Owner's Name and Address MIAMI SHORES VILLAGE -U (An e-€.1 83 Date..._. ��_ _..___......__..._... ,19.. 8 No. ...... Street._.. Registered Architect and /or Engineer L:,. ...••• .................•. Name and address of licensed contractor -- S-s)ti •-) a) ^ LAL %C Kt' E 1 . 0S Location and legal description of lot to be built on: Lot Block Subdivision .._..._...._.... Street and Number where work is to be done 9 3 AZ.. ...0; _...._ State work to be done and purpose of building (by floors) --(s. '*" c-'-. and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation oof Covering Estimated Total cost of improvements $ 0-00 'Y' Amount of Permit $..:14' 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.. 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 employe by him in tkc work to be performed under this permit; and will post or cause to be posted for inspection on the site of th ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to rformed under this pcnnit, as are licensed by Miami Shores Village. Remarks (Signed)_ — — STATE OF FLORIDA, i COUNTY OF DADE. as• Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- pea red - -• - -•— 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.._ ..12. Date Disapproved .'..... _ ...... Date / (Signed) Building Inspector �1 of — Chairman Member Member _.....__....._..._._ .._._ Council Approved Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member — Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval the I'Iannir.g 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, has been obtained from for inspection or faulty 11 3 v 6 13 1 3 &ID MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statc,,,ent or isle 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 nll 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 niust be kept at building during progress of the work. � Date..._... Z — \ ..�... __....._.__....._...198 ) Owner's Name and Address \A:\ C-‘ 1......... Via...._. � �� .. \ , _ _ No... - ...._ . Street._..13) P Registered Architect and /or Engineer Name and address of licensed contractor..,' I i114 " _........... _...._..._..._ . Location and legal description of lot to be built on: Lot Block Subdivision — Street and Number where work is to be done E3 .J_ \)z-_ 1 el l; / , State work to be done and purpose of building (by STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved (Signed) t Date Building Inspector BUILDING INSPECTION DEPARTMENT �•s?.a arc - L. _..__ and for no other purpose. New Bui!ding Remodeling Addition Repairs ' No. of Stories To be constructed of Kind of foundation . *pf Covering Estimate Total cost of improvements $ NOD Amount of Permit 5......! Zone cubage required Plan Cubage _ Distance .to next nearest building Size of Building Lot Niaxirnum 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 %‘'orkanen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the plrovisions 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 th rk such public notice or noticcs as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to formed under this perrnit, as are licensed by Miami Shores Village. Remarks .__._.._ (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared __.....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 fads therein by him stated are .. Permit No.._..� Date......,).. .(.... ..._._ Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commiuion Expires _» ........._..� _ PLANNING BOARD DATE Cirair:nan Member ...._...._... ... ..._...._._ Member Member — Member..... _....._......_..._._ ...._ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hero obtained from the P1. nnir.g Board. A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials anti /or workmanship. BUILDING INSPECTION DEPARTMENT APPLICATICIN FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of me plans and specifications herewith submitted for the build • ine or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florid.t, 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 ttt building during progress of the work. Owner's Name and Address .� " S". /e Registered Architect and /pr Engineer Name and address of licensed contractor /34 — -,, , ...,......._.._.._.. Location and legal description of lot to be built on: Lot , Block Subdivision ,_...._..........., Street and Number where work is to be done 13 -' _/D O r C t L' _ _.._.._- State work to be done and purpose of buj i floors) — and for no other purpose. Disapproved (Signed) Building Inspector MIAMI SHORES VILLAGE Date .._..._..., Date. • / .°? No ........r 3.._... Street...?1 r..J °" Repairs .1 90 No. of Stories New Building Remodeling Addition To be constructed pf Kind of foundation R Covering Estimated Total cost of improvements $ Itf 0 d Amount of Permit $. a t ) ' Zone cupage 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.. The umlrrsigncd applicant for this building permit does hereby certify that he understands and accepts his obligations as an t•r of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Su cnrent, anti has complied ss ith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 arc required by the Act. The undersigned agrees to employ only such su• :.•_ ; - •. ...�•..�.^ , 'formed under this permit, as are licensed by Miami Shores Village, - sr = - ' =__— Rernarks __. —.__ (Signed)..... = - - -- -- !``• ,O/ STATE OF FLOP,IDA, ,Q COUNTY OF DADS. } ss. �"/ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared .. , -•- , to rile 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. Permit Np..,.Z1/ l 1 Date.. I) I Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires., PLANNING BOARD DATE Chairman Member , Member Member rr , Member .. .. , _._ Member , Council Approved Date Disapproved Date NOTE: A charge of 51.00 will be made for making corrections or changes to this application nfter approval has hecq obtained from the 1'I,rnnir,;; Board. A rc•inspection ice of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /pr workmanship.