426 NE 102 St (11)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7 1 a91 ci S b Address E_ Li � I Ooa c j4 r t_ Tax Folio /1 9- 1 O � � I 4 ' gd /
Legal Description / 7 T /O Vii'
'Owner / Lessee / Tenant T:)r.to o rck_ h R . m q Y p Master Permit #
`Owner's Address 4 A(0 t' IOa ney;ne vi,
e, In c�rt� Phone 312k - 3 : s OA)
Contracting Co. 461/ 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 PENCE SIGN
0 DESCRIPTION Pa;rn E.x♦ e.r. ° nr of R Oust,
Square Ft. Estimated Cost(value) $ 1 ) ao c
WARNING TO OWNER: ?- \CE OF' COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOL PROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, 'NDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEM
Application is hereby n Ido work and installation as indicated above, and
on the attached addendu -tify 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.
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED:
Signature of owner and /or Condo President Sig nature of
Date: Date: 7/..
otar,• as to Co
My Commission E
** * * * * * * * * * * * * *
own er- Builder
FEES: PERMIT L ' 7s a RADON C.C.F. / 1 0 ° NOTARY 5 - 00 TOTAL DUET `
**
Fire Other
Zoning Buildin • )p ;.r , ? J Electrical
Mechanical Plumbing ' Engineering
'O
1
Contracting Co. BA/ - Po 1wl g0JL NZd2S Address 1 76 Air, ) 3a I
Qualifier DAM CL L. I BA Phone 69g1 -7q a D,
e66 �,/
State # Municipal # j4745 Competency # Ins.Co. /�113%LtLTI1 J OIpl.4
Date 6- ) 6-93Job Address IX'D J E. )Od C Tax Folio / ) - 3.2,66-0/ 7 -C )C.)
Legal Description 1 "I IN(3 I 9 C ��, (v 8G. 9) Pa /5 J
/ Lessee / Tenant - DE Bo lAQ(-) L MALI t IfIU l Fa go
f� Master Permit 4E gQ
Owner's Address l9 N �^ 10.A )Z Phone
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION PIR -fib S&oc2_ 2i aL¢6Av - q- ? VCAO C: •
1S11 Qa1»° it »f (T C. ?kitJV UJ1-r
Square Ft.
1/00 tt
Notary as .o 1 "er and /or Condo P esident
My Commission Expires: 46g✓
MARY PUTLIC SWI's FL
14Y COr ISSIO1 EXP. CM 13910g6
** * B9NOE0 THAI GENOA M. 6900,
APPROVED:
Zoning
* * *
Fire
Estimated Cost(value)
9 7o. c'a
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 info ..ti is
be done in compliance with all applicable laws regulating eons
authorize the above -named contractor to do the work stated.
Signatgre Contractor or Owner- Builder
Date ' / M
as to C
y Commission
FEES: PERMIT T ?c RADON C.C.F. c�7 NOTARY
Af Do
Other
and that all work will
ning. Furthermore, I
TOTAL DUE /Y 3 6 00
**
Building J 1 J1, Electrical
Mechanical Plumbing_ Engineering
Date 4 2 ( Job Address L4- 2, 10
Legal Description I.� F AT 1 i 7v 1 b `5 Z k'i ) Q YiD Master Permit db
srbP
Owner / Lessee / Tenant /
Owner's Address 1 --(- 2 b• I , F t 6 7 ( , 52S1 Phone7-r 1
Contracting
Qualifier /r//f/A-e
State# Competency#
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Architect /Engineer
Bonding Company
Mortgagor
Square Ft.
PERMIT FEE: APPROVED:
oning
Mechanical
NA0
SS#
Addres
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION a LE pion ce_rpE)0)--z-
�� ) HI 00 St.72.
1 / / E
Address
Address
Address
Tax Folio /�,? / 1 W&'
- — 79 63
Phone
Ins. Co.
Estimated Cost / 04 . a
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, 1 authorize t ,�;,• -named contractor to do the work stated.
&dna"
Signatura,of..,Owne and /or Condo Pr sident Signature of Contractor or Owner- Builder
Date: _
Nota a to Owner and /or Co President
My C- mmission Expires: g /��
Date:
Notary as to Contractor or Owner - Builder
My Commission Expires:
* * * * * *
Fire
Building
Plumbing
Electrical
Engineering
*
*
*
MIAMI SHORES'VILLAGE BUILDING AND ZONING DEPARTMENT
INSTRUCTIONS TO OWNER- BUILDER
YQu have, this date, made application for a building permit as an owner -
builder. You should be advised of the following provisions and requirements
that apply to owner - builder.
Proof of Ownership - Prior to a building permit being issued to you,
you must submit proof of ownership of the land concerned in the
application in the form of a recorded deed, showing you own the property,
or a copy of mortgage or warranty deed of the land, or a Dade County tax
receipt, statement to contain legal description of property and indicate
property is in your name. Legal description and name on document of proof
must correspond to the name and legal description on the application.
Responsibility - You will be responsible for all work done by your day
labor employees, and you must either employ licensed contractors or
persons to be paid on an hourly or per diem basis. Any one contracting
(including labor) with you, verbally or in writing, on a fixed fee basis
for any work, who is not properly licensed, will be subject to a fine of
$500.00 and /or imprisonment for six months.
Insurance - You should be advised that if your day labor employees cause
any damage to persons or property, or if any of your day labor employees
are injured on the job, you are liable. Your regular home insurance
policy ordinarily does not cover this type of liability.
Withholding Taxes, etc. - You should be advised to investigate your
responsibility for withholding Social Security, Federal and State
Unemployment Insurance Taxes and Federal Income Taxes from the wages
of employees working for you on the proposed construction, and for
making returns thereof to the proper agencies.
Work Permitted Owner - Builder - An owner - builder subject to the foregoing
provisions and requirements, is limited to constructing one single family
residence each year for his own use and occupancy; ;or maintaining, altering
or repairing his own single family residence.
If you do not intend to do the work involved yourself, or with day labor, please
list below, the name of the individual or firm with whom you have entered (or
will enter) into a contract for the work.
NOTICE: SEPARATE PERMITS REQUIRED FOR ELECTRICAL, PLUPIRING,
ROOFING AND MECHANICAL WORK
A'L"-- 4 nem Pe q ,2 e(d
Name of Individual or Firm A�dMs `F� - 53 o J S
I, the owner of property described as 4 D., 2 ty f 6
do hereby certified �--
that I have read the foregoing instructions, and am aware of my responsibilities
and liabilities under my application for a building permit for construction work
on the above described property.
Witness Iwner
pr-�S ) g �
Date
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 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 regula-
tions 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 vrork.
Owner's Name and Address AY
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 4 6 r ` 0
State work to be done and purpose of building (by floors) G ti � 1
MIAMI SHORES VILLAGE
Building Inspector My Commission Expires_
Date_ - -- — 1 p
G — s treet _61_ F
i
------------- __and for no other purpose.
New Building _ Remodeling________________ Addition________________ Repairs No. of Stories___________
Roof Covering_— ___________________
To be constructed of___— ___________ Kind of foundation__
o
Estimated Total cost of improvements $_ _ �?� �_____ _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)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, 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 foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N. 5 4084
Work to be performed under this Permit
Owner of
Building
DATE 194_
Architect
Contractor
or Builder
Legal Lot Bl. Subdi
Description vision
Address of - Value of Amt. of
Building Projec 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 appli-
cation 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 respon-
sibility for work done by his agents, servants or employees. w..
Signed • By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform 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 myself, my agent, servant or employee.
Contractor's
License No
CONTRACTOR OR BUILDER BY AUTHORITY