1155 NE 102 St (7)Date
Legal Description
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAI COPY) /1' :5 WO
t_.0' 2 V t 17S Master Permit #
/ Lessee / Tenant NA L b e,r l
Owner's Address < l5 .S N - t() d- s Phone
Contracting Co. A - ( RArp le 1-- 11 4 J-^/ L Address �� �-tl . ( (, S/ //7
Qualifier p u (L. c e_ O Li t Phone ti �-S -'�� 3 -
r
Ins. Co. W ;lt� - o.JL
State C,flCO 4 c1 a`
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING + .CTRICAL PLUMBING_ MECHANICAL P.VING FENCE SIGN
- 5 1 7 173.../ ,).c s CF2
WORK DESCRIPTION a -1-n eitil A s 0 ANc --e, o d 1 , Gi C,.e.. (--2- 1),9 AA /v1/I
e p - , C., . .!- . ejA 5 )e 61 - ��° - t.,ra,, -eAy . (ezer-i-n p C. eQ f f L00A 6e4s,
Square Ft. ! �
qu Estimated Cost ��
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 (it 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 avd zoning.
Furthermore, I authorize the above -named contractor to do the work stated.
Signaturt. o
Date:
Notapv as td Owner and /or Condo President Notary'as to C or Owner- Builder
My Commission Expires: My Commission Expires:
* * * * * * * * * * *
PERMIT FEE: APPROVED:
Zoning
E �
Address �' � � '.� Z. ' SA
Competency #
ner or Condo Pres.
witmeolk
State of Florida at large
M Cot Ewes
r 1I 199?
Fire
Bli nding
V1
ignature
Date:
Q L 1 Tax Folio L t 1 S
of ontractor
Other
Electrical
or Owner- iuilder
. ^ i UWK
:.canes, 11. : 1992
E
* * *
MechanicalLr Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Address 1 5S N . E 1 O a 'S T Tax Folio 7/ ,205 -- / 9 02IV
Legal. Description &#S ,�J /��� -- giS 2,p4. Maslow Permit # 14,
/ Lessee / Tenant -- 7'Y1 ( HALL
r'
Date 4
Owner's Address 1. ( 5 7.5 /1/4) . - t 0 (3. S 1 Phone c6 _ ' ?'1 S
Contractin Co. A - ( � y A'vcQ C J - ) (Address Na LAD . 1 11 )- 1 7
Qualifier o{Z./2i9JC.e C O 0 Phone ( � �s c( 3
State# l r'1 e. Q 4'C1(J� L . Competency#
Architect /Engineer Addr
Bonding Company Address
Mortgagor Address
Permit Type (circle
WORK DESCRIPTION
E 16
Square Ft.
one): BUILDING ELECTRICAL PLUMBING ME AVING FENCE SIGN
�-, „) �.� (�i► i r e� 0,577 3 1 •u @ L, c,i cAL e.07 - =
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 .- work stated.
Signature of Pr
Date:
Notary as
My Commis ion Expires* * * * e *
PERMIT FEE:
h &b
g®.�s
i < /
o Owner a or Condo
APPROVED:
be 11,
Fire
Zoning
Mechanical 40 lo)1� qp
�� ' � bing
Building
Estimated Cost
/�/ / ,f, , Ad
ww or Owner- Builder
S` :nature of o acto
Date:
Ins. Co. Aa.)a)Vi tar 1 hi
anoo �"
Notary to Cont actor or Owner- Builder
My Co
' i k ssionxpires S j mbi Wpm'
QccanW 11
Other
Electrical
Engineering
Disapproved _�_��� �� ° Date
(Signed)
NOTE: A charge of $1.00 will be made for
the Plannir,;; Board.
A re- mspection fcc of $1.00 will bo charged
materials anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statc:m.ne or rare plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Divisinn of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
pl.uts and specifications must be kept at building during progress of the work.
Date
Owner's Name and Address ..C..A.Lai .tt !.A,N CDI iP No 1. /.. ..
Registered Architect and /or Engineer
Name and address of licensed contractor....f Lb2..L.C1t ..._.. .t.a A w......_.. RD.'.!8a . X 6 7.$
Location and le al description of lot to be built on:: a
Lot Block / �J J Subdivision `��RfL�.rr�n..� . p Nc L)
Street and Number where work is to be done 1/ &C i E • JO 57.
State work to be done and purpose of building (by floors) ...
Building Inspector
Chairman
Ntcu ber
\icmbcr ..
Council Approved Date
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,
therein by him stated
�� L e.
Permit No ,. Date '6 )3)19 ................_._ Read, Sworn to
New Building v Remodeling Addition
To be constructed of Kind of foundation
Estimated Total cost of
improvements $ 1 4 0 00 Amount of Permit S.
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Repairs
PLANNING BOARD DATE
' 19 7 5 _._.
and Subscribed before me.
'4rn P491N.. c 4
.
and for no other purpose.
No. of Stories
Roof Covering
Mtaxiunum 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 w ith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed render this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as arc 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. } 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 that he did sign the same, ■nd that all facts
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained fmm
when such re- inspection is made necessary by Improper notice for inspection or faulty