543 NE 102 St (8)Date
Square Ft. / j O 0
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
St , F
Job Address S 3 /V . 102 Si. 33 r 3 $ Tax Folio
Legal Description
Lessee / Tenant i5 /4 Af 6W crI tt,SSf} -jJ Master Permit # 3 5 5 /
3315g
Owner's Address 6 , f E_ rot- r r / N,f)-f- roc, kry , I Phone "98
Contracting Co. AJ, / Address -
Qualifier
State # Municipal
Architect /Engineer
Bonding Company
Mortgagor /US, r c 4 -LE-7" 4L7
Permit Type(circle one): BUILLDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WK DESCRIPTION Prx,.`l m,�� � - S -2.� s Git, l�ll1 U C mANk
OR
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 the work stated.
Sig te: ur of owner and /or Condo President Signature of Contractor or Owner- Builder
Da
,Y
Notary as to Owner an /or Os111c117iLHL
My Commission Expires: IRMA ROMAN
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC006084
MY COMMISSION IXP. MAY 26,1994
** * * * * * * 7
FEES: PERMIT (59 RADON C.C.F.
Zoning Building
Mechanical
Plumbing
Estimated Cost(value
*
Date:
,/A-
phone
Lns.Co.
Address km-o b L. ; 7 t.P
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * **
NOTARY TOTAL D
Fire Other
1 4 1 - Electrical
Engineering
Owner's Name and Address
Street and Number where work is to be done
State w•••:�•. be done and purposeof b ilding (by floors)_
Building Inspector
Chairman
Member
Member
Council Approved Date
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.
1 , s - =
Date
Date
Date
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
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 $ �O ® 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such contractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) tai � (l
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
Permit No P'
Disapproved
(Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
PLANNING BOARD DATE
4
,19
No Street
— n.2. [( c?
My Commission Expires
Member
Member
Member
Disapproved Date
NOTE: A charge of $1.00 will be made for
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.
making corrections or changes to this application after approval has been obtained from
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of ,-
Building
Address of
Building t�
MIAMI SHORES VILLAGE, FLORIDA
❑ PERMIT N° 14046
❑ Work to be performed t der this Permit
t .
Architect
Contractor
or Builder ; t"
Legal Lot II Bl.
Description,
u
Subdi-
vision
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. '+, . -
e r
Signed • , - > . s„. WR � i� ' ...: ,, j
, INSPECTOR
In consideration of the issuance to me of this permit I agree tcisperform the work covered hereunder in compliance with all es 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.
L
CONTRACTOR OR BUILDER BY AUTHORITY
Value of -.""
Project
DATE *'
Contractor's
License No
Amt. of
Permit
•,- J y
$/
4Y
195
;UILDING
LECTRICAL
'LUMBING
)wner of
:wilding
.rchitect
ontractor i r
r Builder c
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
Contractor's
License No.
PERMIT N° 8691
Work to be performed under this Permit
i .
,egal Lot Bl. Subdi-
)escription vision
- ddress of d y ; ; , ! , Value of Amt. of
uilding - S / / / / A ' Project Permit • / t' •
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-
ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
'fans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
i. 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
ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
gulations pertaining to the work covered hereby whether shown on the plans or drawin s or in the statements or specifications and that he assumes respon-
bility for work done by his agents, servants or employees. ' r ' / j
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 pi diriances and regulations
?rtaining thereto and in strict conformity with the plans, drawings, statement or specifications submitted to the proper authorities of Miami Shores Village.
accepting, this permit I assume responsibility for a work done by either myself, my agent, servant or employee.
I ,_1 !:� j t
CONTRACTOR OR BUILDER BY AUTHORITY
Owner's Name and Address ``-'.4
Registered Architect and /or Engineer
G"
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.
•
Name and address of licensed contractor I� f � r • “<'.
1�
Location and legal description of lot to be built on:
Lot Block Subdivision
otl'
Street and Number where work is to be done � � �
State work to be done and purpose of building (by floors)_ ___�^ ? t _ �� � l�s -
Date ( , 19 <a
No Street
and for no other purpose.
New Building Remodeling Addition Repairs
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $___J1 4 3
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
No. of Stories
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 sub ontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
ti
7 Gam
Remarks (Signed) ___�✓��� ' f- ; =
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 0 Ce i Date '� Read, Sworn to and Subscribed before me.
Disapproved Date
� ' i" Notary Public, State of Florida
Signed) l
Building Inspec r My Commission Expires
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
Owne
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N • 4222
Work to be performed under this Permit
BY
DATE
194(
Contractor's
License No
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in t e ppli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be evoked
at any time if the work is not done in compliance with such ord or i f 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 res. onsi.• ty for a thorough knowledge of the or ances and
regulations pertaining to the work covered hereby whether shown on the plans or dray,ngs o i e s -nts or specifications and •. h .7.. : s • -s respon-
sibility for work done by his agents, servants or employees.
Signed. ` """ By
INPEC R •
In consideration of the issuance to me of this permit I agree to perform the work
covered hereunder in compliance with all ordinances r. regulations
pertaining thereto a d in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Mian ores Village.
In ace" tm thi i it I l ss m respol sibility for all work done by either myself, my agent, servant or employee.
AUTHORITY