426 NE 102 St (13){
Date
Legal Description
Notary as t
'MY Commissi
* * *
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
9g Job Address'a2C /Oa''" Tax Folio
Owner / Lessee / Tenant x / or 0. Y Master Permit IF 37
Owner's Address xt � /Oa .,rzear, "47,7/ S,Vc. Phone 7S9 -
Contracting Co. Xr,coze Are oC/ t77, 1NC . AddressS7e 47 /V r4 '
Phone 9'5
Qualifier 1/ t2 rtr,,A71✓
State #CACD '/f /// Municipal 'P Competency # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit,,Type(circle one)): BUILDING ELECTRICAL PLUMBING
WORK DESCRIPTION A6,54OCS �J�/j"7w./G
A6477
Estimated
. /04/ ,24t,i4vox L.dv7Z
er " or on • ' rest
Expires : MIWE LANE
Notary Public -State of Florida
My Commission Expires MAY 11, 1995
COMM. # CC 099203
* * * *
u.�
•
4116
• A
Signature p �
Date: / //O
0
Zonin
Mechanical
President
Address
Address
Address
ROOFING PAVING FENCE SIGN
' 7,' , ' 3/.
/0 /// iteA i,691
ofl
Cost(value). o2, goo,
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT FINANCING, YOUR CONSULT WITH YOUR IMPROVEMENTS
LENDER OR AN ATTORNEY BEFORE INTENI
TO OBTAIN F BEFORE IiECORDINGYOUF
?.,. NOTICE OF COMMENCEMENT).
•
Application is hereby made to obtain a permit to do work and installation as indicated above, an
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,
authorize the above- named'contractor to do the work stated.
n rac •r • vro+
xpires: MIWE LANE
Notary Public-State of Florida
My Commission Expires MAY 11.1995
COMM. # CC 099203
/' /=
mature of Contractor %r n Builder
/ 1
- - - -. r /
Si
Date : //A /9
Notary as to
My Commission
* * *
g
/ C7
FEES: PERMIT (O /- RADON C.C.F. . NOTARY
Fire
Building
Plumbing
TOTAL DUE
�
Other
Electrical
Engineering
(Signed)
Building Inspe Tor
MIAMI S RES VILLAGE
BUILDING INSP CTION 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.
k •
\ • Date '" — 1 — , 19
Owner's Name and Address - 7 11 ' 1 \ \-- 01.1. 0 -- 1 4v. 14.-. ici)....3..4 No... ... .......... Str
Registered kthitect andfor Enginuor ... .._ „„. ,...„. ., „
Name and address of licensed contractor... ...... TM l M
• i• 0 1 132
en-4-Q
Location and legal description of lot to be built on:
Lot Block Subdivision --
Street and Number where work is to be done— ./Q.,04 (2 --
, -- 2A1774 —
and for no other purpose.
State work to be done and purpose of building (by floors
Chairman
Member
Notary Public; State of Florida
My Commission Expires
‘•
New Building Remodeling Addition 'Repairs No. of Stories
•
To be constructed of Kind of foundation
Roof Covering
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 pennit 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 ublie notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontra ors, on w k to be pe under this
pennit, 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
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..._.......a I --7 1 Date ,.c ; 3 Read, Sworn to and Subscribed before me.
Disapproved Dat
to me well known, .
PLANNING BOARD .DATE
Membcr
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-inNpection fee of $1.00 will be charged when such re-inspection is made necessary by *proper, notice for inspection or faulty
materials and/or workmanship.
BUILDING ❑
ELECTRICAL CI DATE "
PLUMBING ❑ PERMIT N? 9112
ROOFING s ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
r;
MIAMI SHORES VILLAGE, FLORIDA
Bl.
Work to be performed under this Permit
Subdi-
vision
Sq. Ft
Value of
Project
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
done by his agents, servants or employees.
Contractor's
License No
r
Amt. of
Permit $
195
I
Signed • / 7 BY
INSPECTOR
- In consideration of the issuance to me of this permit I agree to perform the work covered l�t 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 OR BUILDER
BY AUTHORITY
I7
Street and Number where work is to be done
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
Date
6. 9c No
Owner's Name and Address._.
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivi ion
State work be done nd ureose of building (by floors )._��
0 ,0" - C--* --R.
"4- •9230/1/
Street__ 10.0 4
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
OG-
V
Estimated Total cost of improvements $._ ,Og„D Amount of Permit $_s•
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 5968, 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 hint
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)
wilding I ector
Chairman
Member
Member
Council Approved Date
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 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 9 '// 2 — Date
Disapproved
(Signed) l
Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
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.