1070 NE 91 Terr (9)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 -"
Owner's Name and Address.. ��� L 1 , No.' Street
Registered Architect and /or Engineer.
Name and address of licensed contractor �___ . 41. _C:__
Location and legal description of lot to be built on:
Lot_a 0 Block "2, Subdivision. r < Kj t('
Street and Number where work is to be done 8 0) ''' k, ?R "" C_�_ -1� U(-' -,.
State work to be don and purpose of building (by floors) V /x l 'Lw Nik,'---,k' -
' K u_..•---- r___•- ya R'( e.-._tc: ( %f � °4A and for no other purpose.
New Building .-- Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
, /r \
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 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 5968, 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) -_ `� ��_�} t -" -
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. / —
Permit No 1" � ` �� Date /t' —1 Read, Sworn to and Subscribed before me.
Disapproved j � > Dat Notary Public, State of Florida
( Signed) ....L. -.ma c ice.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chainnan 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 o7 faulty
materials and /or workmanship.
JOB
MIAMI SHORES VILLAGE, FLA.
ADDRESS
INSPECTION
TIME READY
N9 6916
REMARKS.
INSPECTOR DATE
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE. FLORIDA
LJ
PERMIT Np 6272
LJ
Owner of
Building
Architect
Contractor
cr Builder
Legal Lot
Description j j Bl.
Address of
Building_
Subdi-
vision
DATF.
Contractor's
License No.
Work to be performed under this Permit
Value of .Amount of
Project $ Permit y — _
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described i i the upphca!ion
herefor in strict compliance with all ordinances pertaining thereto and with tho understanding that the work will be performed Ln compaancc with ar..y
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may h: rcvo:cd at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon wi ich ;11s rcr; ^ii :a
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and rcqu'.aticr.n
pertaining to tho work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that ho assumes rc no is ii,i ty ',o. cork
done by his agents, servants or employees.
Signed. BY:
INSPECTOR
In consideration of tho issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinanc: and rcguialions
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shor ac•
copting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
C:)NTRACTCR OR BUILDER
BY AUTHORITY
c;
Registered Architect and /or Engineer
Disapproved -.....
(Signed)
Building Inspector
MIAMO SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
,.plication is hereby made for the approval of the detailed statement of ine plans and specifications herewith submitted for the build •
other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
res Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village a nd All rules and
gulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy ref pproved
plans and specifications must be kept at building during progress of the work.
BUILDING INSPECTION DEPARTMENT
Owner's Name and Address MR & MRS PHIL Co DONNELLY — N01070 Streee
e Date
lYN R o RRADP ORT)
Name and address of licensed contrictoe DEAN CLAUSSEN
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done X 1070 i\T E 91 TERR
State work to be done and purpose of building (by floors) ADDITION TO GARAGE TiONT & 711CLCS:;)s __......_......_
GARAGE
_.._._ and for no other purpose.
New Building Remodeling Addition X Repairs No. of Stories
To be constructed of '- Kind of foundation CO�TC `E �t STEEL Roof Covering �3L'I�,T l��'
Estimate Total cost of improvements $ 2000.00 Amount of Permit $.
Zone cubage required plan Cubage
Distance to next nearest building.. Size of Building Lot 75 125
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 froi all contractors or sub -con ctors employed by him
in the work to be performed under this permit; and will post or cause to be posted . inspection on the sit oft c w rk such public notice
or notices as arc required by the Act. The undersigned agrees to employ only su• . ntractors, on or t performed under this
permit, as are licensed by Miami Shores Village. '24.1 d �i o
I f .7:--!
Remarks (Signed). —
STATE OF FLORIDA,
COUNTY OF DADE. j 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 careful) read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. v� q p
Permit No .._.11Q C/ Date .._'.1. \` 11 9 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Mcmbcr
\Scz bcr Mcmbcr
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 hen obtained from
the Pl.inniu;; Board.
A re- impection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection faulty
materials and /or workmanship.