AWNINGS56.3'1 AFFLLO CHAT Co N FOR
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractoe
WAMil SHORES Voce,
BUILDING INSPECTION D[EP
Crrr Smith et Associ^tes
JALCC a I N
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)
New Building Remodeling Addition
therein by him stated are true.
Permit No..1-..- 1 - .. -. Date
Disapproved
(Signed)
Date. ._...
Builds Inspector
Chairman
Member
Member ...... — .._._.
13
TMEIT
ME
MOLDONE PERM 07
Application is hereby triode for the approval of the detailed statement of the plans and specifications herewith submitted f u7 ehe bei :d-
ing or other structure herein described. This application is made in compliance and conformity with the Building' rdinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all ctrles cad
regulations of the building Division of Miami Shores Village shall be complied with whether Therein specified or not. A espy off app;r v
plans and specifications must be kept nt building during pa grew of the worts.
,
�'HIL
C. 13C'27,3LTL l'3o. t _...._.. �3 _ � . o 9
A. w..«_ .w w w.o
The undersigned applicant for this building 7ennit does hereby certify that he undcrsta
of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled
and has complied with the provisions thereof, and will require similar compliance from a
in the work to be performed under this permit; and will post or cause to be posted for i
or notices as are required by the Act. The undersigned agrees to employ only such au
pennit, as are licensed by Miarni Shores Village
Remarks._._ (Signed) _ ..w.....
7L1 N. 5Lth Str°eC't..a.......: "'�� a.. o 33 :
Install aluminum fold -down a
and goo c� a h E ac sR
To be constructed of. Kind of foundation Reel Coverfng
Estimated Total cost of improvements 239 a CG a CC
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 ite construction may
be sent eo .. _ 7eldon :ocfF a uoE °.sore JiLCC I:�'C 7L1 1' 51'Lz � �__.. sr d
STATE OF FLORIDA, t
COUNTY OF DADE. SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and tat a 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 ate, cad that a1 few
7
Read, Sworn to and Subscribed before natal.
Notary Public, State of IFloaidn
My Commission 1Eepirca
i3 NINC BOARD DATE
Repairs No. off Stories
s and accepts his obligations as an employes
eral ii.nws c2 Florida, Pennnne•nt Supplement,
ntractoas e7 sub - contractors employed by him
ion on the site of t e work such public notice
ern, on Gi °d to be p i nd r this
to sate wellPaorn,
Membee
Member
Member __.._ __._ ................_....�_.___
Council Approved Date Disappecrvedl Date
NOTE: A charge of $1.00 will be made fee making onneeQio:aa oa chanson ■e 11'^f3 cpgAieaQia nftea apaaaso•a9 D:na C-i cn a a.12.niae Tuann
the Planning Board.
A re- inspection fee of 81.00 will be charged when Me?a B'eetEriP in roc 1 0 eecc y (bq Tamp a aa3f &V fc aETrf) CS' 2 ^�r3Y
materials and /or workmanship.