101 NE 102 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /oVet, Job Address /0/ //e Tax Folio
Legal Description Historically Designated: Yes No
D/ /A /79
Owner's Address /o/ 7
Contracting Co. -22,5
Qualifier 0 - Le5 f f -
Owner/Lessee / Tenant
State #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
FEES: PERMIT 3 RADON
APPROVED:
Zoning Building
Mechanical
Municipal # Competency # *1 f Co. C�/'--/ 2L%
Address
Address
Address
WORK DESCRIPTION /2/?e-36 � w
/az. �
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.
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 r ture of Contractor or
Notary as to Owner and/or Condo President - t' to tracto�ef Own er -B Date
My Commmssron Expires: My Commr OFFICIAL NOTARY L
` P R d 6' S MARGARITA MONTIEL
N � l CONMIS.` ON NUMBER
1 �� e� cc797277
P MY GO?1...]SSION? ES
` OF FA DEC 17 , 20 02 02
C.C.F. • 0 NOTARY BOND
Master Permit # 4‘.6
Phone r? - 4 5 6
Address `j J 7-"( /727
7// ,
3-G—
23 6 -6/ c7
Electrical
ui la
/`; 6- .°0
Date
TOTAL DUE 6
Plumbing Structural Engineer
��
Date' ,2z - 73 Job Address /GP/ /i`'. /02P57
egal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
• As &V.4 '3 7+ S Sea: / /Mb
Owner / Lessee / Tenant TER cl , Master Permit #
Owner's Address fie/ /V/= /02 ' S ! /4 44 51tini'< Phone 7 -7 j 4/ /o
Contracting Co. /11/: ) L/3/r Address /G& 5 a,vl V /zit Si! y /) /A /'
Qualifier 41/3t ,,p/ 4= 43)t Phone3 °3 4 271/.33
State # /- L Municipal #60-2q//3 Competency # oho /.3 Ins .Co ./ /e1Cda11/
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
P ermit Type(circle
FT ORR DESCRIPTION
** *
APPROVED:
* *
one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVI FENCE SIGN
Square Ft. Estimated Cost(6alue)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMEN 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
be done in compliance with all applicable laws regulating construc
stated.
authorize the above -named contractor to do the work
Signatue of owner and /or Condo President
Date: it f 42/ 93
AF /l
ar as to Owner
My Commission Expir
JOSEPHINE CHURCH ortru
y i e 30,1
vr., ` A. No. CC197545
• �i.�• r •
*
FEES: PERMIT ,? /• 5 U RADON C.C.F. - F 0
N ary s to Con
My Commission Ex
NOTARY
Mechanical
Plumbing_
Tax Folio /1 8,,206 /.3 /774
u,
7-5p
accurate and that all work will
ion and zopir4W. Furthermore, I
Signa ur of Contr ctof"or Owner- Builder
Date: /20/9,
JOSEPHINE CHURN
io rro dDsrflerirBute bra
:My Commission Exp. Apn130, 1
,4 „ No. CC197545
* * * * * * * *
TOTAL DUE A(3, OD
Other
Electrical
Engineering
`pia► .,.w0...1%
. • • ,
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.
Owner's Name and Address 0. 1LLA-f..,/
Registered Architect and /or Engineer
Name and address of licensed contractor ine 4i8 - 4e.
Location and legal description of lot to be built on: yy��JJ
Lot ` 1 (C) Block 1 Subdivision 2 4
Street and Number where work is to be done \D` N E.. 10 ]-
State work to be done and purpose of building (by floors), state exterior colors, samples)
Spaghetti
j//4//,.• / .,
5670W
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
-4' Date
Date
Date
No. tflt
�. (A . a_o....
Notary Public. State of Florida
IN 19
Street 1 J E.• t O o.-
St
/ // s ad /3 /19 s �
a•: for no other purpose.
New Building Remodeling 1.- Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S � CO Amount of Permit s 4,1(of
b ° "
Zone cubage required Plan Cubage
Size of Building Lot
loor
rations for said building. All notices with reference to the building and its construction may be sent to
ig permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida \t'orkmen's
mpiled General Laws of Florida, Permanent Supplement. and has complied with the provisions thereof. and will require similar
tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed
mi Shores Village. n
(Signed) O _4 _ 2 S
, 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, that he has carefully read the fo egoin• application. and that he did sign the same. and that all facts therein by him stated are true.
Permit No. Read. Sworn to and Subscribed before me.
Disapproved
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 525.00 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 525.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.