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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.