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620 NE 101 St (7)Permit Type(circle WORK DESCRIPTION Signature Date: / Jam oiary as My Commission Expires: FEES: PERMIT )W11 APPROVED: Zonin PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date fob / /7 /9J Job �'ress 6)2° Nig (0 /SCE . .ri; .e/y // 41 Legal Description i Owner / Lessee / Tenant Idl ,PS - c A- ( u (e 1 c Master Permit # 3�� 9/ Owner's Address 6:::), H /6/5 l Phone 7S 2 c?? ?`, Contrac 4 / %17/ 1I i2 r Address /9 d1 9c:, Qualifier ./ ) f r vai c. SS4# - Phone L ; g_.? 2d 2/ State #0'tr 0,36 ? l lcipal # Competency # 7 / /(n Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Mechanical one): BUILDING ELECTRICAJ., ,LUUMBING MECHANICAL ROOFING PAVING FENCE 27;/‘ f . (.....%/V - A Square Ft. Estimated Cost(value) /991)6 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 don in compliance with all applicable laws regulating construction and zoning. Furthermore, I author ze the above-n•med contractor to do the work sta L.%:. � •� nd /or Condo :President td Owner and /or Condo President cc : , : . s :1I:'' d �.! �:X� r.; -�a„ 1 , , �� y � QED I al dy ��•'. : li lS. INS. W�0,c yy RADON Plumbing Date: 0 My Tax Folio / , � / 19t' O Signare of Contractor or Owner- Builder ary as to Contractor or Owner -nu � Commission Expi t , � ';i =5't� : E\( 1. ?2. £ = i s3Gi'10cu Yh:J Ca 7 , 1 E.73. C.C.F. ( l , ° NOTARY TOTAL DUE tl I�✓ Fire Other Building Electrical Engineering SIGN R R R 10./0 /tS 2 MIAMI SHORES VILLAGE STATE OF FLORIDA, COUNTY OF DADE. } ss. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT New Building Remodeling Addition To be constructed of Kind of foundation Estimated Total cost of improvements $ 1 and has complied w ith the provisions thereof, and will require similar compliance from all contrac in the work to be performed under this permit; and will post or cause to be poste o rosye,e tion or notices as arc required by the Act. The undersigned agrees to employ only su th sybco &Era pcnnit, as are licensed by Miami Shores Village. Remarks. (Sign r Application is hereby sonde for the approval of the detailed statement ur ore 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 progreu of the work. Owner's Name and Address . 4" E ill d Registered Architect and /or Engineer Name and address of licensed contractor _._...—.: Location and legal description of lot to be built on: Lot Block Subdivision . .._. ...__ . ....._....._ ._... ._...._. i Street and Number where work is to be done k A, 0 A7/ jell _ ...k! ... �:_._...,. el 1`' Y Stat work to be done and purpose of building (by floora)..� J F L�.�..�1_t.ra..LL. _. �, cr.. a and for no other purpose. Repairs No. of Stories Roof Covering Amount of Permit S. 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 fur this building permit does hereby certify that he understands and accepts his obligations as an employer of Lebur under the Florida Workmen's Compensation Act, being Section 5066, Compiled General'.aws of Florida, Permanent Sup Clement, rs or sub - contractors employe • .by him of the ork such . lie notice under this Bcfore me, the undersigned authority, a notary public, duly authoefcd to administer oaths and take acknowledgments, personally ap- peared Disapproved (Signed) Member Date Notary Public, State of Florida Building Inspector My Commiuion Expires _._. Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has the P1. nnir.g Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for materials anti /or workmanship. — .....to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. , / Permit No..__Q.. .5 ../1 DDate el .�.C�. /A p v Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Chairman Member Member Member Member __. ...._ _..__... Date been obtained from inspection or faulty BUILDING El Date SHORES VILLAGE, FLORIDA 30– 23 Date 19 ELECTRICAL ❑ PLUMBING ❑ PERMIT N? 10558 Contractor's 9 � ` � � 7 ROOFING ❑ License No. ❑ Work to be performed under this Permit ? trIn.. t //4_ 14/ e Owner of +' Building l ei k$ /i/ ii # L t- f J r./ i/ a. c it ! S —t, _ 2- 1 1 t 11 a 1 V.- -. Architect Contractor or Builder r ` (-).-2.) Legal Lot j Subd Description Bl jj iCnii- n Address of Sq Ft ' "� �-� ` �G7� % Value of �� Amount of Building I Project $ ��'" 11 Permit $ / 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 an 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 as mes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or dra or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servagts or employees. Signed • : -' INSPECTOR) BY In consideration of the issuance to me of this permit I agree to pert rm the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, state nts or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by eit r, myself, my agent, servant or employee. CONTRACTOR or BUILDER r) I _ BY AUTHORITY E3UILDING 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 baild- 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 Addres Registered Architect and /or Engineer. -. Name and address of licensed contractor ■ Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done b 2_.Q N / 0 / s �VU State work to a don and p se of building (by floors)__ bO ztt 117- r Ik -- &Ca. Ct iA __ - - - -- and for no other purpose. New Building Remodelir,.g t ''' ''. Addition Repairs No. of Stories To be constructed of Kind of f undation Roof Covering / Estimated Total cost of improvements $ .. J �0 .W._ 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 STATE OF FLORIDA, COUNTY OF DADE. j ss. Disapprove ( Signed) Date Buildin _Inspector MIAMI SHORES VILLAGE I� 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 him in the work to be performed under this permit; and will post or cause to be posted f inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only su contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks- – – (Signed) "41seei .7 -. J / ////n/ 1117 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 are true. Permit No 1 1 O Date ..__ A_P ... _ Read, Sworn to and Subscribed before me. Date to me well known, Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman 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 been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.