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MECHANICAL?rrrnit No MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Build g Inspection Request Datc Type 1 P 'n I_ f Name `� _ --- --- — Address _.. Al d . _....1�. --- A C 1-1 Q 2 Company Phone #f J j tnspectian Date . �...,.„�„! f �! Approved Correction _ . // Re- ?nsp'n Fee Q MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Date 0‘ Type Insp'n Permit No. Name �i Address C ✓ _S7 < . C ULLt___ Company Phone # Inspection Date Approved Correction Re- Insp'n Fee Zpor■sti 3 OS 1-1 v fi re MIAMI SPORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date J -hAJ/k Permit No Type Insp'n t . , n . HL ?OZ — )v Name ,rM ,� / C.�- CL.� —>�J Address 4� /tie ! 0 / Company e 7 Phone # (6 a/ -ea Y / Inspection Date /7// Approved ❑ Correction ❑ Re- Insp'n Fee ❑ Type istvp'n .Permit Name Address ie_a )4 it-' Crnpain Date Phone P4 ' Insptletion Date . Corretgion , Re-burn Fee MIAMI SHORES VILLAG BUILDING DEPARTMENT 305-795-2204 Building Inspection Request, MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date t' ` Approved Correction Re- Insp'n Fee O Type Insp'n /A h (� Permit No. A/C 0 / f 11 5 Name ��/I6 Address `it C N /co Company 1, e Phone # 7/6 - 63 92 Inspection Date /// Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10/12/2004 Applicant: DANIEL FINKELSTEIN Owner: FINKELSTEIN DANIEL JOB ADDRESS: 444 NE 101 ST Contractor C & R AIR CONDITIONING CO Contractor's Address: 2121 NW 139 ST #10 Local Phone: 305 - 685 -6394 Parcel # 1132060170461 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2004 -183 Legal Description: AMD PL OF MIAMI SHORES SEC 4 Permit Status: APPROVED Permit Expiration: 4/4/2005 Construction Value: $3,205.00 Work: EXACT REPLACEMENT OF 3 TON SPLIT SYSTEM ON WEST SIDE OF HOUSE. Page 1 of 1 PB 15 -14 LOTS 6 & 7 BLK 90 Fees: Description Amount FEE2004 -10021 Building Fee $120.00 FEE2004 -10022 CCF $2.40 FEE2004 -10023 Training and Education Fee $0.80 FEE2004 -10024 Technology Fee $3.00 Total Fees: $126.20 Total Fees: $126.20 Total Receipts: $0.00 OCT 1 2 ENT'D In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATION FBC 2001 City /Y1 1 ! A w1 .S k 0 r cs State PI _ Tenant/Lessee Name Is Building Historically Designated YES Architect/Engineer's Name (if applicable) Architect/Engineer's Address City $ Value of Work For this Permit Number of: Bays Stories Type of Work: ❑Additi.n H ❑Alteration ❑New Describe Work: A., ,9„. 4 Minus Plans Check Fee $ Miami Shores Village Building Department 22 ®S . °a i NO r Families Permit No. NC 2004. / �3 Master Permit No. Zip 33 12 Phone # IBECEDVED T 0 6 2004 :1Q N.E,2r4Aveciue o .1 - ores, r loriva 3.3138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing echanica Roofing Q Owner's Name (Fee Simple Titleholder) or Fi r 1\ e' �ft(n Phone # 3 O 1 y • (S O Owner's Address 444 N E t o t s ( Job Address (where the work is being done) 444 N £ (d 1 City Miami Shores Village .County Miam ade Zip Contractor's Company Name C-* ( A, r CO ' C[ . C 0. Phone # 2 0 S 6 o 6 3 q 1 Contractor's Address P. 0 . b X 6 e(<3 0 0 City 1 q Yv 1 ' ' � r I ¢ S AI F F1 Zip 33 1 48 Qualifier (. O he ( T L C h r y S'T Phone # State Zip Total Fee Now Due $ l Square Footage Of Work: Bedroom Baths Repair/Replace ❑ Demolition d IJ * * * * * * * ** *� * (0)'qb* ****Fees****************************** County Escrow Fee $ I J � � Fee $ ! r Notary $ Education/Training Fee $ Tech $ / — SerdW Radon $ Code Enforcement $ Bond $ Struct. $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the . building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature NOTAR Sign: Print: chc7/7/03 Owner or Agent The foregoing instrument was acknowledged before me this 6 day of ©C , 20 0 by who • personally known o me or who has produced As identification and who did take an oath. c My Commission Expires: , +:�yy ,; Robert 3. Chryst MY COMMISSION# DD113321 EXPIRES APPLICATION APPROVED BY: Con actor The foregoing instrument was acknowledged before me this 6 day of O Gt , 2001, by who s personally lento me or who has produced as identification and who did take an oath. NOTARY PUBL Sign:. y sr Print: T -- J �� ' -- P 1\ rq h ' " y ; . • Janet Kranz My Commission E4I3 • -• .: MY COMMISSION # DD174033 EXPIRES .��� • December 24 2006 • ** BONbEDTHRUTr �a Nef Competency Holder) State Certificate or Registration No. C A CO2641 { Certificate of Competency No. 0 L d 8 0 3 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** /t, / 7 J S 4.c Plans Examiner Engineer Zoning T UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE . T LIGHT OUTLETS CENTRAL HEATING I: I O t s'.'J MASHER RECEPTACLES A/C (WIND) 0SAL SERVICE TEMPORARY A/C (CENTRAL) 1 7.31 h (KING FOUNTAIN SERVICE SIZE IN MPS DUCT WORK , Al Ff i- Ohd . R DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION _ LSE TRAP APPLIANCE OUTLETS PROCESS AND PRESS (PING :RCEPTOR RANGE TOP UNDERGROUND TANKS 1TORY OVEN ABOVE GROUND TANKS DRY TRAY WATER HEATER U.F. PRESSURE VESSELS HS WASHER MOTORS 0- 1 HP STEAM BOILERS hER MOTCRS OVER 1- 3 HP HOT WATER BOILERS 4, POT /3 COMP. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION : <, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMCLIES K. SLOP MOTORS OVER 8- 10 FP ELEVATORS/ESCALATORS PCRARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER. SYSTEMS NAL ',TORS OVER 25-100 HP COOLING TOWERS ER CLOSET MOTORS OVER 100 HP VIOLATION ARECT•WASTES A/C WINDOW REINSPECTION ER SUPPLY TO: AIR CONDITIONERS • •JC UNIT STRIP HEATER IRE SPRINKLER GENERATORS TRANSFORMERS • ,EATER -NEW INST. GENERATORS TRANSFORMERS I ?EATER- REPLACE GENERATORS TRANSFORMERS AN SPRINKLER -WELL SPECIAL PURPOSE • >W I Mf 1 I NG POOL OUTLETS COMt,ERC I AL CATER SERVICE SIGN TUBES ER CONNECTIONS SIGN TRANSFORMERS L I1Y -SEWER SIGN TIME CLOCK LITY -WATER FIXTURES 'TIC TANK ANTENNA AY TELEVISION OUTLETS ■INFIELD, 4' TILE/RES. VIOLATION P S ABANDON SEPTIC TANK REINSPECTION ME PIT CU. FT. 'CH BASIN ;CHARGE WELL . ' : AESTIC WELL EA DRAIN JF INLET 1 • _AR WATER HEATER I . iE STANDPIPE A. PIPING 'N SPRINKLER SYSTEM 3 RANGE TER SET (GAS) ' 3 PIPING ADDENDUM TO BUILDING PERMIT APPLICATION APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL circle): J ob Address (where: the work is being done) City Miami Shores Village Is Building Historically Designate YE ee Simple:Titlehol S Value of -Work For this Permit._ 1005 .E.2ndAvenue Miaini:Shore , Florida 33138 Tel: ;(305):795 Fax: ;(305) Demolition emit, '; . Owner's Nan e wner' Ad ECEnvDrD MIAMI SHORES VILLAGE BUILDING INSPECTION 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 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. • Owner's Name and Address.. ./1./.t't- Prf.,%Ida A t I giStt'fed Alchitcvit ilitdldr Lngine.0,... , n•u.•I v:uutuau:m1:,. •uma.uenumtnu sin ntrnme Name and adaress of licensed contractor . „ �, ,�,,,„ „_ „,,,{„2,`� / , ( e _� � -- No._ ... St LV d Location and legal description of lot to be built on: L.L. ed-. it• Block._ 7 0 Subdivision Street and Number where work is to be done ' / ®1_, State work to be one and purpose of buildi (by f1 rs).- ....-- �Cllre i.-? __5f . --.. ..._. _ .._..•- •---- -. -_ -- -,� - , --_,_, and for no other purpose. New Building Remodeling --.. Addition Repairs. — No. of Stories.._. To be constructed of Kind of foundation _._. Roof Covering Estimated Total cost of improvements $ ' _Amount of Permit $ S o • 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, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by hint 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 performed under this . permit, as are licensed by Miami Shores Village. Remarks-- - ..... -• - ...._. (Signed). ..... : _.. STATE OF FLORIDA, COUNTY OF DADE. 1 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 si the therein by him stated are true. gn same, and that all fact Permit No. / . 90 Date./.� _ .Z ,. Read, Sworn to and Subscribed before me. Disapproved Date (Signed) NNING BOARD_.., . ...._._.... .�._- DATE ............. Member Member Member .._ ... ........ Date Disa NOTE: A charge of $1.00 will be made for making corrections or changes to this application after apps al has 11 Planning Board. A. re-inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for materials and /or workmanship, Chairman M:crnber ...- _....- Member Council Approved - ._ uilding Inspector • Notary Public, State of Florida My Commission Expires Pprov ..._..»._.- ...._.._..--- _.. -.._ ••.•- _..-_- to me well known„ ..._;_ ..».._._..Date been obtained from inspection• or faulty • t•. • NV 1 ,0c 1 1 °N E sr FGO �r MIAMI SHORES VILLAGE 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 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. Date Owner's Name and Address...Dr' C 1.._._..._ » _ » ._, Std 1O1 s t Street l egia tetttd Afchithll atld /be 1 Hgliteue..!. t ll.,• ,. :ru... " lllltIIIMI!Illlel l! lllll Minting' IMlllll11tMalIUMUUMIIMtIMMMbttMMtIMMU #MftttttMMMMMU Name and address of licensed contractor.tG.G'�te., „H eating and Air Conditioning ».. . 5 N4ti -- -- - gb-- Location and legal description of lot to be built on: Lot......._._. _ Block . „........... ............... Subdivisi Street and Number where work is to be done.. J �? i N.E. 1 �� 9r e e t State work to be done and purpose of building (by floors) Add 3 Ton Air Gonduttio'ning System -- _ _"'._- „ „... ---- and for no other New Building......._...._ Remodeling ...._. Addition... Repairs. No. of Stories.._. To be constructed of Kind of foundation ............. ... - Roof Covering—.-.--.-.—. Estimated Total cost of improvements $...1 8 00,r ��.... »» ..— _...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 ..... ......... ...._... : 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 5968, Compiled General Laws of Florida, Pennanent 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 under this- -7 or notices as are required by the Act. The undersigned agrees to employ only such subcontra • on work t b p erformed h permit, 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 aclmowledgmedts, personally ap- peared to me well known, of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, facts therein by him stated ar I ' z S Date. /� Z / 7° and who, being by me first duly sworn, upon oath deposes and says that he is the. Permit No. Disapproved (Signed) BUILDING INSPECTION DEPARTMENT ._... - Member Member Read, Sworn to and Subscribed before me. Notary Public, State of Florida PLAI,V G BOARD.........._._... DATE Chairman - Member Member - --------- .--- -..- -- Member Member Council Approved ......... „Osl Disapproved _ NOTE: A ch rge of $1.00 will be made for making corrections or changes to this application after approval . __. • r —Date the Planning Board. Pp has been from A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper motive far inspection out f materials and /or workmanship. qt . Permit No / 9 Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT � 7 Date .. Oa ! /7 /.! ^ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. �/ l Owner's Name and Address. ' Dt (� n �+ ` sTE No 1 / 1 / 4 1 Street.. 4 V1 / S Registered Architect and /or Engineer _ C I .y Employing Electrician's Name 1r N 1 ' D) -.E IU C- No 369 g Location and Legal Description Lot Block 55. qyy Street and Number where work is to be performed —No �+ - State work to be performed and purpose of building (By Floors) sJ ! O N New Building Remodeling Addition Repairs No. of Stories Service Overhead on Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation— Conduit Tubing B.X.L .Metal Moulding (Signed )...Z A1..R.. ....... aoa1.P - Electrical 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 Sectipn 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. (Signed) .. Street 544) Subdivision Street g S- /0/ `Sr S 7_ Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. 4. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. M OTORS 0.1 HP M OTORS I.S HP N EON TRANS. RADIO TOTAL CONTR. LIST / CHECK ■ Permit No / 9 Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT � 7 Date .. Oa ! /7 /.! ^ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. �/ l Owner's Name and Address. ' Dt (� n �+ ` sTE No 1 / 1 / 4 1 Street.. 4 V1 / S Registered Architect and /or Engineer _ C I .y Employing Electrician's Name 1r N 1 ' D) -.E IU C- No 369 g Location and Legal Description Lot Block 55. qyy Street and Number where work is to be performed —No �+ - State work to be performed and purpose of building (By Floors) sJ ! O N New Building Remodeling Addition Repairs No. of Stories Service Overhead on Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation— Conduit Tubing B.X.L .Metal Moulding (Signed )...Z A1..R.. ....... aoa1.P - Electrical 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 Sectipn 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. (Signed) .. Street 544) Subdivision Street g S- /0/ `Sr S 7_ Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. 4. be sent to ,eel Mr Vi .a &..r� i �J y�o_ CO_ /'n ,'ossi./ l,,- �-- % -to'� , _ 4e ,..>:(I �'Lo mom_ nej MIAMI SHORE$ VILLAGE 471 BUILDING INSPECTION IDEPARTMENT 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 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. J o & 7 8 8 S .4---1° ,,__.t3_� n Z.47 , 19.4.1 Date__ Owner's Name and Address e C��- e �v e __ �i�' . 1x_C._ttia3T ! _a/ No Street_iV.4'- Regitered Architect and /or Engineer. Name and address of licensed contractor_.__ 6"e/41 b Q /s2 4 ! Gave .ta- C-o a /° 4 ? 6- J � TH Z A ve Location and legal description of lot to be built on: Lot__ Block Subdivision Street and Number where work is to be done y-..K ! • / 'O ( State work to be done and purpose of building (by floors)._ _ a__ _S r /'4_L__L_ 4 - C— Z! IU ,!_L Lt� O le /C - /4: -J J' 4 .Q l i. _. j 4�' — — S! t? _ 67Y_..__4,_ _. _. and for no other purpose. 4 New Building Remodeling £. Addition Repairs No. of Stories To be constructed of Kind of foundation__... Roof Covering Estimated Total cost of improvements $ • 4 9 • 5 — Amount of Permit $ / - v ` Zone cubage required .y ___._ 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 foi said building. All notices with reference to the building and its construction may e s /..i !v e Nit L i i-i f - - - ° 6W/4 ry b 4 ! v /9 C . The undersigned applicant for this building permit doe hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Sec ;ion 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. Remarks ( Signed) r== L...r' ._ U_ _.�+ - �. 7 ; e. 7 78 ,5" 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 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 stated are true. Permit No 9O - Disapproved (Signed) Building Chairman Member Member Council Approved_ Date __/ 6__7 at pector Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD__ __ .. . _.__. 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 male necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHORES VILLAGE, FLORIDA 'BUILDING ❑ Date { 19'' ELECTRICAL ❑ PLUMBING ❑ PERMIT 9285 ROOFING ❑ Owner of Building f'` -t'`� Architect Contractor ' :, {> f / or Builder` Legal Lox 11 Description 11 Bl Address of Building �' } / /a/ This permit is granted to the contractor or builder named above to construct 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 specifications and that he assumes respon- sibility for work done by his agents, servants or employees. �¢ Signed• ° . ` - 1 4 """" (INSPECTOR) BY In consideration of the issuance to me of this permsI agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plan ,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR or BUILDER Work to be performed under this Permit Contractor's License No. Subd vision Sq Ft. Value of +w' 11 Amount of Project $ " 't " �' 11 Permit $ BY AUTHORITY ' rs