FUMIGATIONOwners Name and Address
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement ur sire 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
Shorts 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 cupy of approved
plans and specifications must be kept at building during progress of the work.
Vin
Registered Architect and /or Engineer
Nam* and address of licensed contractor FUEL l(.r Cn
�.....__ — No..11 C D ..._... $
Location and legal description of lot to be built on:
Lot Block Subdivision .
rr Y ( .. .
Street and Number where work is to be done L..Q.Q Kt�1_..cl.
State work to be done and purpose of building (by floors).....lL11.1.1.L
11.11 ttt•••ttt• 111 tt••• tttttt C11 •.1
1AL... t. h
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation. 11 Covering ) Estimates Total cost of improvements $ Our v v Amount of Permit S. 1 __
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 riirrlersigned 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 st ith the provisions thereof, and will require 'far compliance from all contractors or sub - contractors employed by him
;n 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 s on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j as.
Before me, the undersigned authority, a notaty public, duly authorized to administer oaths and take acknowledgments, personally ap-
p eared - -. — .—
Disapproved
(Signed)
Building Inspector
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 be 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.._ . ✓ ! PQ) Date ,))1 1 Read, Sworn to and Subscribed before me.
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 frmn
the I'Lrnnii,_
Board.
A rc•in•pr•c•tion fee of S1.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials anu /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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. ,19
.._ August . � _
__.._... ..8-
.» No... .�1�....__. Street_1I..E._9.8_..Streetr
Owner's Name and Address J. Grout
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) Nylon Tent Fumigation
Vikane 18 -24 hrs. 29,000 cu.ft.
_..__ 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 $ f.0.0 Amount of Permit $. ‘ /.1.012
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
............. .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be r performed under this
perrnit, as are licensed by Miami Shores Village.
Remarks (Signe
0 'kin Exte zpir.>$.ting...G.a,,
1960 N.W. 27 Avenue
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. Q� �� 1
Permit No. ._._. 411 Date -/ {/
Disapproved
(Signed)
Building nspcc
Chairman
Member
Member ...... _....._..._.�.. - Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- impcction fee of $1.00 will be charged
materials and /or workmanship.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
PLANNING BOARD DATE
My Commission Expires
Member
Member
Member
Disapproved
or changes to this application after approval
Date
has been obtained front
when such re- inspection is made necessary by improper notice for inspection or faulty
PEST-CONTROL •
World's Largest EXT.E17 COT.P.PANY INC.
0 1960 •NT:I 27 Avenue
land, F1. 33125
LOCATION CF STRUCTURE........alfailasalLatinat_._.„-----..---
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FUlaGATION iinalCATIOTT
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CARD JDER IN CHARCY
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1.1,LEPHuilE : : 633
NI 624-6865
,y. 73a1th Dept
Dupt
heriff;s
ANOTHER ROLLINS SERVICE
N TI.
ULBL PR AT ALL TMES IN STRICT ADI TO THE
REGISTERED LA.131-.1 AND FLA. STATE BOARD OF Ti.F.,ALTE REGULATIONS°
FAC,
1960 N.W. 27th Avenue, Miami, Florida 33125 Telephone 633-3421