25700New Building
To be constructed of
Estimated Total cost of improvements $
Zone cubage required
Distance .to next nearest building
Maximum live load to be borne by each floor
STATE OF FLORIDA,
COUNTY OF DADE. J s
Chainnan
.Member ................
Member .. ...
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or the plans and specifications herewith submitted for the build
ine 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 spetdfied or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date
Building Inspector
q _k_ . 0 , 40 (
PLANNING BOARD.
NOTE: A charge of $1.00 will be made for
the I'lannirng Board.
A re fee of $1.00 will be charged
materials and /or workmanship.
Date
Owner's Name and Address 1 , ......... ».d
Registered Architect and /or Engineer u ,
Name and address of licensed contractor a�
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done. ././
State work to be done and purpose of building (by floors). »2..x:6.. . »:.
1 .J �.< � :
r... ..... ....: ».i ... � ... ...1 L. l I s . ..:.»:.":9.,, �� 1 and for no other purpose.
Remodeling Addition
Subdi vision._............».. »._..... »....._ ................ .._..� .»
Repairs No. of Stories .............:
Kind of foundation...._._...._.... Roof Covering
Amount of Permit $..
.. ..Plan Cubage
.. _ Size of Building Lot
.ff Tit* ••• •ftf *tit tnlfftntnMT•fnnMutnl -n
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, Pennane•nt Supplement,
and has complied with the rovisions thereof, and will require similar compliance from all contract • or sub - contractors erttp)oyed by him
in the work to be performe under this permit; and will post or cause to be posted for inspection • e site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su • . n • ct • 's, - work to be • donned under this
permit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
Before me, the undersign. n .> •. 'ty g6ta y public, d authorized to administer oaths and take acknowledgments, personally ap-
peared
•
DATE
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida --
My Commission Expires
Member
Member _......_.........._......_ ..— _. .
Member
......_. Disapproved .._.._._ ..._._ ...._.
making corrections or changes to this application after approval has
when such re- inspection is made necessary by improper notice for
to me well known,
and who, being by me first duly sworn, u •- oath deposes and says that he is the. ..
of the above described construction, that has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated � aarre�true. .
t
Permit No.. ( 5201.. ..
Disapproved
(Signed)
Date
been obtained from
inspection or faulty
CHASTAIN FENCE COMPANY, INC.
901 N. W. 143Ro STREET
- 76
I t t t
• MIAMI. FLORIDA 33168 • PHONE 688-0541
• 1q,„k'
' • •
-
4-13C— I - 1 2 C. I Cis's"; 1
Buirdeu. of Bettzt, genes
Miami cihores9Illage
F L OR ID A
PLANNING BOARD AGENDA OF Ot7013tTR. Sill ITEM NO.
asN0445 Assoc.. ANC.
Name of Owner /Applicant RRAty 0141`4,itAl'fY Phone No.
Address of Property, and /or Legal Description )14500 14S
Nature of Request N?PRQdAL. Of Wrki tle,
Present Zoning S-1
Area of Present Building
Area with Proposed Addition
Parking Spaces Provided
Parking Spaces Required with Addition
Setbacks as per Code
Setbacks Provided
Variances /Exceptions /Zoning Change
Council Action Required T
Date of Applicant Notification
Planning Board Action Po r PFa
Council Action \OfR,3
101mM
tt,akaw
Director of Building and Zoning