Roof repair 1973MIAMI 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 building
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 regula-
tions 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__w.
Owner's Name and Address No.__________ —_
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___ !z___— _
State work to be done and purpose of building (by floors)
----------- - - - - -- �_ and for no ether purpose.
New Building_______________________ Remodeling___________ Addition__________________ Repairs No. of Stories
To be constructed of___— Kind of oundnion Roof Covering___��_._ ' _ _�_��
l
Estimated Total cost of improvements $ - 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 the .site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigncd authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that be 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 Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
Notary Public, State of Florida
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.
MIAMI SHIRES VILLAGE
UILDING ONSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address �' ` 7,Zeji
Registered Architect and /or Engineer
Name and address of licensed contractor 4l./...! .... t1i..4 4. 4 i
the build -
of Miami
rules and
approved
Da _.� .. . Strut.._ _._o....... ,19,`%y
Location and legal description of lot to be built on:
Lot Bock Subdivision
Street and Number where work is to be done. /Z// ' 4 .„g V'7i -`9 /� 1d,?.(;---g7
State work to be done and purpose of building (by floors) �%f�u ���'� -- - •�'1-.--!-:
sod for no other purpose.
Remodeling Addition Repairs...�� No. of Stories
Kind of foundation Roof Covering
Estimated Total cost of improvements $ � � 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 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 performed v�der
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
New Building
To be constructed of
STATE OF FLORIDA,
COUNTY OF DADE. SS.
Bcfore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments,
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.
/-s 21 - Date / ( 7- Read, Sworn to and Subscribed before are.
Permit No..
Disapproved
(Signed) 7 ( ..� / \.
Date
Notary Public, State of Florida
PL a '.NING BOAR;a DATE
to me well known,
Building Inspector \. My Commission Expires
personally ap-
� /,
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 tmproper rta3fco for inspdtion or faulty
materials and /or workmanship.