1270 NE 102 St (3)Date10/24/95 Job Address 1270 N.E. 102 ST: Tax Folio 11 32 05 025 0031
Legal De�pfi� MIA SHORES: Historically Designated: Yes No NO:
Owner/Lessee / Tenant OWNER : k l / / /,C Master Permit # 32'523
Owner's Address 1270 N E 107 STRF:RT MIA SHRS . Phone 758 -5674. 79- . 113 /0 c. 1(
Contracting Co. 0 4' /CIF,.. 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 DESCRIPTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
WALLS:
40Dri h_
Square Ft. �' Estimated Cost (value) � /H
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YO _ = dAY
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.)
Signature of owner and/or Condo President Date
ROBERT C. MILLER.
Notary as to Owner and/or Condo President Date
My Commission Expires:
l'EES: PERMIT ' 1' RADON
PAINTING F.XTRRTOR OF ABOVE RESIDENCE:
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 regulatin: construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOF.' 1 G an. • ! CHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is acc .ate and that all ork will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above - amed c n .rte o the work stat
Sign: turf-pf Contractor or Owner-Buil w Date
Notary as to Contractor or Owner - Builder Date
My
C.C.F. j NOTARY
TRTM•
. PSZ PO OFFICIAL NOTARY SEAL
0 new SANDRA IA MONTIEL
4 c ,� * COMMISSION NUMBER
`r CC401261
NY COMMISSION .EXP.
7 � �ec Fn m
6 7
TOTAL DUE(It 40
APPROVED:
Zoning Building I0 % Electrical
Mechanical Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of t�
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
ja.i tile #10
CONTRACTOR ORB ILDER
MIAMI SHORES VILLAGE, FLORIDA 11 ,,
F �:� L 195
PERMIT
1N° 13468
Work to be performed under this Permit
II , Bl. Subdi-
vision
DAT
Contractor's
License No
� 104 Value of .r. Amt. of
t a, + / 0 - Y1 f I , Project $ ‘9-40.. i 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 application
herefor in strict compliance with all ordinances pertaining thereto and with 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 responsibility for work
Signed • s BY
done by his agents, servants or employees.
INSPECTO \�
In consideration of the issuance to me of this permit I agree to pe -• 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, m —yyellf, my agent, servant or employee.
l
BY
AUTHORITY
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.
(� (t Date � _1 Z 3 , 19 c
Owner's Name and Address_Ttf YL__ft JS.1�_j_�' V A-1 No. Street
Registered Architect and /or Engineer
Name and address of licensed contractor _ _III_ �r_1 Lt) __ciL S_aC n• LA). 13]r 3f
Location and legal description of lot to be built on:
Lot Block Subdivision Si: Street and Number where work is to be done ,I a b f R • 1 0 7
State work to be done and purpose of building (by floors) Pst.J.r ' Oy_- - }ei�r_t e. ZA_ ,fly,
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
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 $ g� �� 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, 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) _Ji LI. £ Jt-
6 L i in la.
0 kv k
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 Date 2- ' Read, Sworn to and Subscribed before me.
Disapproved o f - Date
(Signed)
Notary Public, State of Florida
uilding Inspector My Commission Expires
PLANNING BOARD DATE
Chainnan 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.