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560 NE 102 St (4)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) f Job Address 6 J`- / /6 2 5 Tax Folio f ✓o / / 17 / ,r/ Legal Description, ,% nivi) Pf- ' Master Permit # (rtes La-pipte / T-etreet vOv,, \z \AA° Owner's Address 5 6 lv 13 Z.. 5 -- Contracting Co. j Lv/1 (`/ WORK DESCRIPTION / s a�t � Signature of Owner and /or Condo President Date: Address lj ( 0 w E ! 6 7. 5 A' Qualifier °phone State# Competency# Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN Square Ft. Estimated Cost g& 0o 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. 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. 1 S'gnature of Con�tor or Owner - Builder Date: „re/a/4,k Notary as to Owner and /or Condo President N nary as to Contractor or Owner - Builder. E i : M Expires: My Commission xpiresy Commission xpires:,S/ r i�G * * * * * * * * * * *� * * * PERMIT FEE: APPROVED: Fire Other z ga Zoning Building # WV 19( Electrical hitre 0.1,41 C Q r .9 Mechanical Plumbing Engineering 4 phone 756 - G 3 6 .s PLANNING BOARD AGENDA OF .4 /D 4 ITEM NO. Name of Owner /Appl i c a n t 'J O # / 1 / Phone No. 7 c 3 ?; Address of Property, and /or Legal Description c60 /y aT /O Sf Nature of Request „ael�/9( O� Q�ydlr' 4,2- Ite/.0/1 r Present Zoning 2+"/1." Area of Present Building Area with Proposed Addition Parking Spaces Provided aiami chores91llage F L OR ID A Parking Spaces Required with Addition Setbacks as per Code Setbacks Provided Vari ances/Exceptions/Zoni ng Change Council Action Required No Date of Applicant Notification Planning Board Action 'CP M-fl )0019) APP'S( 16 ) 22 Council Action ki.tkamk Director of Building and Zoning OoS2s> # w►& F- • 0 I- ) � �— 56 ,Jc io2 A STG,J t r•I S'- ..vrc. 1 - k (4-3 (,(...€- // 4, 1- 3" a -0 Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING D ELECTRICAL ❑ PERMIT N? PLUMBING El N . 8 5 21 ROOFING ❑ ❑ Work to be performed under this Permit Bl. Subdi- vision Sq. Ft Value of Project $ DATE 4 -4 - Contractor's License No `. Amt. of Permit $ 195 7. 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 tilt statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. • Signed: 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 oc employee. - BY AUTHORITY ss. Owner's Name and Address. _. /.I..r_ 4 J-_A_) 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. Registered Architect and /or Engineer Name and address of licensed contractor- .i.t2�dLl Date r "! . , No Street Coo, 2. 7 f g- / o A v-e (4A( p4'- Location and legal description of lot to be built on: Lot Block / Subdivision Street and Number where work is to be done r 6 . �-P_,� �� fi//h/ State work to be done and purpose of building (by floors)_--- . ACV h'ldl,0 : H:p .IFS et and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundat' 0 Roof Covering Estimated Total cost of improvements $ 9 9 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 a site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, vvtprk to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed)_ f / _ - Cl L�� —a STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ----------------------- to 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.- _... �t Date `f= Read, Sworn to and Subscribed before me. Disapproved Dated (Signed) Building Inspe �r Notary Public, State of Florida My Commission Expires ANNING 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.