ROOFINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / / -02 Job Address f9 Af E jJ o (5
Legal DescriptiorPMM3 h C)/
Owner / Lessee / Tenant I l l l fi A UPI //I / & 1 Master Permit it j 9 i
Owner's Address q /1J C /6 a 5 Phone -26 / -5 F5
Contracting Co. ( (1/ /- y iftD f,.rl j Cad-Ira 1 = &JC- Address 5 / AJ (d 1 £4 t 5 fi
Qualifier CA r/ ac /rOG /i O SS# Phone 7 / - a
State . IPA Ci 0Sg 4, 29 Municipal # c907 8'96Q Competency # / ? 8 Ins.Co.
Architect /Engineer Address
Bonding Company ' Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL
WORK DESCRIPTION T e t i / ► 4 , j _ ( c" U - J ! �
A e •f e e -c d� i p aM.dd o orn
t .
Square Ft.
FEES: PERMIT 36<e0 RADON
APPROVED:
Tax Folio /� 1 /
PLUMBING MECHANICAL OFING) PAVING FENCE SIGt
�,(1.L 1 vh- fnr
a
,2 Estimated Cost(value) it 5,1-/l)C,OO
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO Dc
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUI
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 th
standards of all laws regulating construction in this jurisdiction. I understand that separat
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 wil
be done in compliance with all applicable laws regulating construction and zoning. Furthermore,
authorize the above - named contractor to do the work stated.
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Si ature of owner and /or Condo President
Date: L)av• / /9 9.
9
Notary as Owner = • r'-,
My Commission Expir= ANwr�' •. • ARY - 70.OU MFNNANDE
,t.; CCA1A1i2R1ON # AA 714214
l j 10, 1993
F ' E�II�iMt:�:OcPAb rr
c'` . Wilder) mro NOM PliWic Undarm1ters
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C.C.F. ®
Zoning Buildin
Mechanical Plumbing
Signature of Contractor or Owner- Builder
Date: / 001). / / yq.Z
4 .4.../
Notary as , Contractor or Owner-Build
_
My Commission
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w NIA OU HERNANDEZ
e ti M Y COMMISSION 0 AA 714214
i r EXPIRES: October 10, 1993
* *
NOTARY TOTAL DUBJ/3 D e
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Fire _ Other
V/ Electrical
Engineering
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General doecdpeton 01 Improvements 6--A Huberorci ° r
Address /
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Fes SimPle TIM. holder 01 ether lbw ovnise)
Expiration Date: .-O 93
Swan to and subscribed beim nu, des
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Any poem amedng • Imo for the constinctloa al the Improvessita:
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f:laSION # M 714214
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9 2 R 4 289 95 1992 NOV 12 10:11
moony 4.nisers Prod liedIfiestion (Feb) Nosberts):
Ma AIM TM UNE MI IIIKCISINNI 008 VAN MOVE TINS 1.111 100 MIMI MU
Notirt of Tominenttment
"WAAL IN INPUONTIO
I9 Wpm It map =tern: Building Permit No.
The undersigned hereby Informs ail concerned that improvements will be made to certain real property, and
In accordance with section 713.13 of the Florida Statutes, the following information is stated In this NOTICE OF
COMMENCEMENT. .
.
Lao twaraiption et mi lady undue. fusel Address, II melbas) . e(3.. .... 10 ,. g..... .
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Pen" within the Mats of Florida dollantand by owner upon whom notices or other documents may be served:
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In addition to himself, owner designates the following person to receive a copy of the Uenor's Notice as provided
In Section 713.13 (1) (h), Florida Standee. (Fill In at Owner's option).
Remarks__. __..___.__
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. / e
Owner's Name and Address .._..e � 1 / 1. .c . _._�� _... _ . No. - N4treetl a —52.
Registered Architect and /or Engineer......!e.a.- 'tier - KIcaIXA
Name and address of licensed contractor. S X 11.E f Sj
Location and legal description of lot to be built on:
Lot Block ff lubdivision
Street and Number where work is to be done iii-.- ✓ T
State vvigrk to done d purpose building (by floors)
- - � - h og_ j �, urpose o 1 - — Mad
and for no other purpose.
New Building Remodeling Addition Repairs 4'i ' Z o. of Stories
To be constructed of Kind of foundation Roof Covering a 12
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
floor Maximum live load to be borne by each
plan and ppcifi ions for said building. All notices with reference to the building and its c onstruction may
IT
be sent to.
- ---_ -/ e e_.5 AO 9 I. Ca-- ---j 3 5 N
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 ch public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, • • work to be per armed under this
permit, as are licensed by Miami Shores Village.
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.. . /S ' Date.__ 4 -7- r Read, Sworn to and Subscribed before me.
Disapproved L 2�
(Signed)
Date
( S i g n e d )
Notary Public, State of Florida
to me well known,
Building Inspect .r My Commission Expires
LANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved 0 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.