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1025 NE 91 Terr (11)Owner's Name and Address STATE OF .FLORIDA, COUNTY OF DADE. ss. Permit No.._» ._.._ .r` Disapproved (Signed) Ciiainnan Member Member .. .. Council Approved Date MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement ui me 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 i)►►il.li►►c 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. Registered Architect and /or Engineer �� tl l�G� h ... Q '� Name and address of licensed contractor � � ��� �.._... � ®...._.f... �� .._. � ��� .s. v ....,., _ -_ Location and legal di scrintion of )` `� 1' „; t t c built on: ✓ / G Q `� �� c�. Lot � 5 3 f )�7 3 Subdivision- eZ1./i...L %mG t:.��z : P 71 / " �. ' ��.d .... Date BUILDING INSPECTION DEPARTMENT Street and Number where work is to be done. .._...._. _ —. ..�� „,.� State work to be done and purpose of building (by floors) 1• .. TB.�. ._._ No.4 ® w. Streed2 .. ..! and who, being by me first duly sworn. upon oath deposes and says that he of the above described construction, that he has carefully read the foregoing therein by him stated arrrtrue.. ��IIII Date Before me, the undersigned authority. a notary public, duly authorized to administer peared -_ - - -_ UM n1• •„1,11nlM..! Read, Sworn to and Subscribed before me. NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval the I'Iannir.z Ilu.►rd. A rc•rn *pe tion fee of SI.00 will be charged when such re- inspection is made necessary by Improper notice n►atcrials anu /or workmanship. ..... and for no other purpose. New Bui :ding Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation ........ ..._. Rolf Covering Estimates Total cost of improvements $ Amount of Permit $. - Zone cubage required .....___..._Plan Cubage Distance .to next newest 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 un,ler.icned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a•mpinyer of Libor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida, Prominent Sup sle►nent, and has complied with the provisions thereof, and will require similar compliance from all contract s or Sufr•ccntractors employe cl by him in the work to be performed under this permit; and will post or cause to be posted for inspection Z site of the wont such public notice or notices as are required by the Act. The undersigned agrees to employ only such subco tractors !t ' stlgi"lit be performed under this pcnnit, as are licensed by Miami Shores Village. Remarks. .._ ( Signed) oaths and take acknowledgments, personally ap- M ..................... ._..._._......_..___ - ......to me well kn is the. application, and that he did sign the same, and that all fads m .s Date.._...._.._. — _ ._k ii Notary Public, State of Florida Building Inspector My Commission Expires......._....._... .® —..®.® • PLANNING BOARD ..._.._ ... -DATE t Member . - Member Member Disapproved Date has been obtained from for inspection or faulty )3 59 / 3 c/--/ S 1 r cA MIAMI SHORES VILLAGE, FLORIDA BUILDING U ELECTRICAL r_� DATE —___ -_ _ _ 195 PLUMBING PERMIT N9 8778 Contractor's License No. - _ - — -- -- ROOFING -i L� Work to be performed under this Permit_ - Ovmer of Building Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER Bl. Subdi- vision Sq. Ft Value of i Amt. of Project $ 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 application 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 �rork 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 an the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY s; 7 .f • !Y . .. ilr rt',U .;�.. ] .wrg . t;�dla R .,,,., r+ � ottni w.r: 4i?; .;.!, 1 tAi�' ,tn�tl.:r c , 1 : irn s:... ct ) r., n : ?i., _. '.ac'. ■'II coat n; r,'.t to ws'. - w • r 0' 31 :n<�..�irr :.�.�r:-c:`er!:; a c �. �,: � �.� a '+Q ri a that Cklitalmvai 9 4;1111 ` Arra "J a di mkt. saki ,.. cta ie i etc, a s"rz, ' r6 umenrriti Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: STATE OF FLORIDA, COUNTY OF DADE. ss • 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 .9 c: �. , 19 Owner's Name and Address6 -' ��'��!� i � ��- �a�-i No G � 4 - Street. 'in. %f _ /��• v'! ,c/ - a — State work to be done and purpose of building (by floors) , L C L.CA._s. va ? ;.: • • L •'. , S �",) •' , it .* ) 1 C, Lk- ' Lot 'L Block Subdivision..._. eS�� Street and Number where work is to be done / and for no other purpose. New Building \G Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ I L `'i, C.. . c-C "" 7. 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 n be sent to. , , :_�: . _d._ .L. , - �> �. - - �, Z. /( _/.6:11,'✓ > k u - ;. �_aK ` The undersigned applicant for this building permit does her certify that he understands and accepts h is 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. ` l� f ` r P Remarks (Signed) ___1, ` \ k Z�_ `L ) Z:, �- - 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 farts therein by him stated are true. Permit No.__ „ Date 9 . - ( jtead, Sworn to and Subscribed before me. Disapproved _ Date (Signed) Buil ing Inspector °/ Notary Public, State of Florida My Commission Expires PLAN NG 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 frail: the Planning Board. A re- inspection fee of 81.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.