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MECHANICAL
Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description Owner / Imosear4.4emegit e/1I'1 Rf.6 S (V' ICkIQS Master Permit # Owner's Address 69 N E / O a ST. Contracting Co. - l � P ,ifi s\ C F f R. Address Qualifier A ( ke i 5 kr SS #. - S 3'� * 00 -/ O 61,x+� # 4 .512,04ABetency ## Ins.Co. Architect /Engineer ,-�' 1 Address Bonding Company Mortgagor `,�' Address ,` Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN a WORK DESCRIPTION I rot Ce E s+(iJ G pA C V19 g u Al W rri--1 CARkteR. sop" 0 36 SE .ER I a d Cost(value)r800_ Square Ft. ** * APPROVED: 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 •licable laws regulating construction and zoning. Furthermore, I authoriz -jT above -name° co or to do the work stated. Signature of owner and /or Condo President Date: Notary as to Owned a i0 • io%�resident My Commission Expired A� ��; * : o.. o #CC 384336 ) °. Bande * * . A Ve%.lets���.• �2 UBU STAt t FEES: PERMIT 30.- �E �y -4 C // o Zonin Mechanical Job Address 69 /V& / /O.? J x Folio Building Address Date: Signature of Contractor 8 o Owner- Builder owliumom Notary as to Cp1tl4V My CommissioieEx 4.. . * * * * * Si o• ▪ #CC3843 6 '_ Y ' • 1, e anded0 c :O C.C.F. NOTARY % STA AL DUE 3/ va ili �� ` ' �� 1 Fire Other ?* Electrical C fPlumbing Engineering f MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑` Owner of � r Building Architect PERMIT Contractor or Builder if Legal Lot Description 11 B1 Address of /' l Aga, Building ��1 CONTRACTOR OR BUILDER • N° 5641 Value of Project $ • DATE ,±;".- '?/ • & V19 Contractor's License No. // Work to be performed under this Permit • , TB S di- vision Amount of 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 applica- tion 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. Signed. — 7 - -%•••• 1 • / ' �, �a(v � � . SPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance witty all ordinances lotions pertaining thereto and in strict conformity with the plans, drawings, statements or spgcifications submitted to the proper authoriti6s of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of - Building Architect Contractor or Builder Legal Lot II I Subdi Description Bi vision Address of Building Value of II Amount of i t i ( Project $ II 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 applica- tion 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. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 5686 Work to be performed under this Permi DATE 19 Contractor's License No. BY AUTHORITY Signed- Y INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances °811H regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ABBOT T 3 N1' 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. Date — I 1 _ �' l , 19 Owner's Name and Address._... . I.. T,__._fM_L.,~..K.(`_n,L_S. No '7 Street 4.0.2. Registered Architect and /or Engineer Name and address of licensed contractor D _./�_ ©._lv 0.�:,_..�v_GV Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done (q I(, c • )0-2_ ST • State work to be done and purpose of building (by floors) 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 $ /S °•"- Amount of Permit $ to - 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 -- 2..1.a rs� -�-- -i e d �EQ -1�/ ) eS? -Qi-�1 L 6 /1-1$ L S. FLA- 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 t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work o performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) _ 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 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 — c / - Y Read, Sworn to and Subscribed before me. Disapproved Date (Signed) c-- e- IC , Building Inspecto Gamely to me well known, Notary Public, State of Florida 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.