PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date t 0 —1 S Job Address ( (o i 4.c to 1 Sftt l Tax Folio
Legal / -- /
C�( ?w Tenant / Tenant / r C-Z ( a L 'Z S
Owner's Address .4 z? / 4 • • /0/ 5T/ £
Square Ft.
WARNING TO OWNER: 1
RESULT IN YOUR PAYING
CONSULT WITH YOUR LE
Application is hereby made to
certify that all work will be pe
permits are required for ELECT.
OWNER'S • FIDAVIT: I cer
laws re _ 0 0�tion and A tikOr t
Signs
FEES: PERMIT RADON
APPROVED:
Zoning
Mechanical
tbdr
d/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Building
Plumbing
Historically Designated: Yes No
m
Master Permit #
Phone kg-6 �8
Contracting Co. �--et-1/•i CF R- - Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION t L h NcE g.itf k C_ P 1 1 - 'e --
;value) 5 O
'CEMENT AND YOUR FAILURE TO DO SO MAY
ERTY (IF YOU INTEND TO OBTAIN FINANCING,
lG YOUR NOTICE OF COMMENCEMENT.)
d above, and on the attached addendum (if applicable). I
)nstruction in this jurisdiction. I understand that separate
MECHANICAL WORK.
igna j f Contrac or or_
at.: -work- '11 be done in compliance with all applicable
r. for to d the wo ted.
otary as to Contractor or Owner - Builder
My (`..,,,,,_.,_ Fxnirec
tip;RY 'PL® i1AL NOTARY SEAL
o 4i SANDRA M MONTIEL
el C OMMISSION NUMBER
CC401261
EAY COMMISSION
AUG. 17 990
C.C.F. NOTARY 5,
Electrical
-'2 22 -
oN Se-1-1
er- Builder Date
Date
BOND
C7
TOTAL DUE 4 46
Engineering
Date 5/18/92
Legal Description
Owner / Lessee / Tenant
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Add eAs 461 N.E. 101 St.
Fla" /7 4// 010,.//44 -
East 10 Ft. of Lot 19, all Lot 20 and West 1/2 of Lot 21,
Mitchell S. Polansky
Owner's Address 461 N.E. 101 St., Miami Shores, Florida 33138
Contracting Co. Address
Qualifier 0�Lji1 }Ylf e SS# - - Phone
State 1 Municipal 4i Competency # Ins-Co,
Architect /Engineer Address
Bonding Company Address
Mortgagor - Address_
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN
WORK DESCRIPTION Paint exterior of house and garage.
Square Ft. Estimated Cost(value) $1,650.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENI
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU/
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
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:
be done i
authoriz
I certify that all the foregoing information is accurate and that all work wil.
with - pplicable laws regulating construction and zoning. Furthermore,
contractor to do the work stated.
Si
D
A gaikabo
t a
re o 11 = n d/p�- do President
di
0
l 'i,e;r(;)/56 . U�
Nota y •s o Owner and • Co9r WIkesiden Notary as to Contractor or Owner- Builder
My Commission Expires: � FFICIAL SEAL My Commission Expires:
DEIaDRE M. KING
:,,•r,+:
MY COMMISSION EXPIRES
* * * •�� ° OP rw;r * JANUARY 09, 1994* * * * * * * **
** *
APPROVED:
FEES: PERMIT i 7, s O RADON C.C.F. AO4 NOTARY TOTAL DU e'�Q
Fire
Zoning Buildin
Mechanical
Plumbing,
Tax Folicll f• 'o /7 D
Master Permit/ 1P ,3024
Phone (305) 751 -2377
, PB 15 P. 14
771 1 0 71T11 FENCE SIGt
Signature of Contractor or Owner- Builder
Date:
Other
Electrical
Engineering
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 the work.
i
algAr D 6
Owner's Name and Address // /eh/. ��+ � L /We/5 �/ "NO• yc / Street / U
Registered Architect and/or Engineer
&cI / C/t
Location and legal description. of lot to be built on: V
Lott / 29 0'' W/ 9 Subdivision -7/1,,e
Name and address of licensed contractor
Street and Number where work is to be done
State work �to be done and purpose of building (by floors), state exterior col s (submit samples)
/r
cz' C - /b Na6�lr )(A / -4 k/
Palm SciMOles on heick
New Building Remodeling Addition Repairs
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S / ' 00 Amount of Permit $ T51 ( f
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 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 obligatons 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 agree employ only such subcontractors, on work to be performed
under this per as are licensed by Miami Shores Village.
Remarks
Permit No.
Disapproved
(Signed)
STATE OF FLORIDA
COUNTY OF DADE.
•
1 SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ack Howled n ts. person appeared
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.
Da
Date
(Signed)
7/ ..70 l
obirf;
•
Read. Sworn to and Subscribed before me.
Notary Public. State of Florida
No. of Stories
and for no other purpose.
to me well known.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
Angel Fur A 12-1W
Celestial Glow A 12 -2W
Salmonette B 12 -3W
Titian t
B 12 -4D
Kabuki Orange B 12 -5D
Incarnadine A 12 -6W
Prawn A 12-7W
Trumphet Bud A 12 -8MT
Shrimp A 12 -9MT
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 regula-
tions 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.
Q
Ownei s Name and Address — 6 ' .N,,ra -)r)" r^
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Da
? -- Street.-12-LE 10 / .sf
Subdivision
Street and Number where work is to be done `
v 7 •
State work to be done and purpose of building (by floors)
/.
New ' Building_ __________ Remodeling __ Addition Repairs No. of Stories_
•
•
To be constructed Kind of foundation.
Estimated Total cost of improvements $ — — Amount of Permit $_
Roof Covering
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 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)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 area true.
Permit No.__ w!__ __ Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed) _.
Date
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
__and for no other purpose.
4
to me well known,
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 inspection or faulty
materials and/or workmanship.
__Date
MIAMI SHORES VILLAGE, FLORIDA
BUILDING MI DATE r
ELECTRICAL - 1 111 PERMIT N° 5849 Contractor's
PLUMBING) License No.
rl Work to be performed under this Permit f
r" ' '`
Owner of i _
Building :i t i i V i �L. t'" /"C'
Architect
o r�Bt ,s A /'t f
Legal Lot
Description
Bl. Subdi-
vision
y
19441
•
Address of / /1 f 6 / 1 .r Value of Amt. of t ,
Building' / l L/' / ( ) Projec f Permit / f,,
"'�.+
This pennit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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. r
Signed• e'' ) I" _' !r 1 ' t ( By
INSPEcybR
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 responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY