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636 NE 101 St (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date L' : - 15 . F c , Job Address h.( J ;, t_ 1 t, t r" ( - 7 r Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant _ A C e \, `- A r *' ■55'c2i L Owner's Address (3 6 /1)4 / Q / f `` S/eQW' Phone &5 937 3.56"C Contracting Co. /kme_ tCOrt e- -- Address j��� /o/ fA sA . Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Address Square 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. OWNERS 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. - Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical RADON C.C.F. Building tlfolo Si e o ' ontractor or Owner - Builder - 1. g �ON FI as eta 17,200 Notary as to Con My Commission E NO Y Master Permit # Electrical BOND eticl - t) go-rc Date or or Owner- Builder Date of ptGAL NOTARY SEAL S MAROAWTA MON-r1EL el#C1Q CCC797277 Mg9pN NUMBE * TOTAL DUE Plumbing Structural Engineer 11\ a) ■.) r 0 I cEprrx flip • • tiOttiftzt6 citOtiMikif ' • :•••.71 •.-AlwrOlgtgt- ttttictit 14641144V 41\ _ re. / PAN/a-MC:et-17 PAR'zve,i4y 1 1 • • . • • • • • • 1 7"; - 0 P6"1- 0 R . : . zZ4.11 • N • A C.1' C A C. L' 0 ..............2"•••••••• • IS./ I ■1 I rq /6.7! / IQ •.: ", •i% i M. z' 2 , gy , c, t, vi •• e G • • 0 • 11i 4 . 1.' Z 11.1 ' • '"5 ■dioi ;• 1-...- vi: .1 • . 11. /1, V Col.,•■ •• .• 1 . le• a , . ',., - .• g iro, ✓ ,. • .. , •, i••4 .• . iz1 . t•ITI1 ' . \,.•/,,e c'' F.--.'•J'-' ... r. .6.1.21_1,:.....' 42 '-‘------•r-------- 0 P—: , • 0 7 ? .,,i,...;. :------; 4 ,-1 ..------ A'•■ 0' .) 9 9 4,Pe • . ' - . " • • ;•'4! . • • • ••••;,, • '• • . • • • • " • - - ;,..; • • • .f ! P ••••• • ' • • • k ' •• • • • • •. • • , • Paintirsg Plastering Lathing Electrical Mason & Concrete Plumbing Roofing Glazing Tile .- + moo • Miscella.neo. - w C ONTRACTORS .w+ • • '• • ARCHITECT BUILDING PERMIT RED IAMI SHORES VILL4GE FLORIDA DATE APPLICATION Application is hereby made for the approval of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in com- pliance and conformation the Building Ordinance of the Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all Ord.inan.ces .of -Miami Shores Village, and all rules and razulations of the building Department of Miami Shores Village, shall be complied with, whether specified or not. OWNER f1 1 ONTRr CTOR LOT ,/„�, BLI /A3 SUBDIVISION ' 'SThEET ` NEW ADDITION REPAIR: NUMBER OF STORI L-=ROOFt,4. COST (excluding Architect's fee, landscaping & garage) Building to be used for ie /.(4‹ and no other use. 4- I hereby submit all the plans and specifications for said building. Signed .. .�.. .. _ STATE OF FLORIDA) J COUNTY OF DADE ) YY -- Before me, the undersigned authority, a notary public, duly authorized to administer oaths and 'sake acknowledgment, personally appeared to me well known, and who, being Vy me first duly sr.orn, upon oath deposes and says that he is the builder of the above described construction, that he haseread the foregoing; application, and that he did sign the same, and that facts stated by him are true. Read, Sworn and Subscribed before me, Notary Public (Signed) • My Commission expires � r Cubic Feel �¢ ''ubic feet required in this Block // PLANNING BOARD Chairman Member Member Secretary Building Per' t a, Date tubing Permit No. / Tenant Date ‘-22.- cf q Job Address 6'34 AYE 1i9/ fk Tax Folio Legal Description PERMIT APPLICATION FOR MIAMI SHORES VILLAGE n7 1-5 6 Atict 7 &v.- V t Historically Designated: C) ' t N1 Yes\ No Master Permit # 9 J d GAL . c2S 6&o Phone — 30S 7:6 196 / 6' IC- /P/ Contracting Co. A FJta7. ,ey_,» C rPf2 l t Address 5,7/926" S � Qualifier SS# State # Municipal # Competency # Ins. Co. Owner's Address Architect/Engineer 1 /9lie,u ( 1-4 1 Address Bonding Company Address Mortgagor Address Permit Type (circle one) BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION l ©O F /12 1a !r-t (` I'1 6--- 7fl 9O T3 v l 19?So/Ze r 4 /iv /r2s C Estimated Cost (value) Square Ft. 1416 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND OUR 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 ork stated. Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT 115 RADON APPROVED: Zoning Mechanical Sign 4- /0 C.C.F. /1 - Yo NOTARY ?o ?v ca yq tfve 0211m/ 33 73 '6055 57gq Electrical Phone o _ . 11 e • Contra or or • wner- ilder ?)-.)7611 5 ' �y otary as to Con or or Owner - Builder Date My Commission Ex - 0 j/ C: BOND 300 TOTAL DUE 9 3 '--" Buil'iJq )19' dm�;�� Plumbing E gmee ng Date 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 -' t Z. Registered Architect and Engineer.. ( Name and address of licensed ed contractor Location and legal description of lot to be built on: ,,,,.,.,�tt Lot 7-6 -Iv 6- Block /03 Subdivision- -._ 1%Y r.� 77 ,. - ' / Street and Number w ere work is to be done 6,36 17' e. / 0 / , Date t &V / ' .22 No..- _. C7!,:/ Ir/ Street -- o/ 124)13A, State work to b done and purpose of building (by floors 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 $.- ./- . 9_.6o6 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 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 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. J 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.__ ��I / /2 , 7 Date /1J' 4 A 3 Read, Sworn to and Subscribed before me. Disapproved Date ? �<�j l Notary Public, State of Florida (Signed) Building Inspector 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. / . e. /0 , ack..