1184 NE 91 Terr (9)Registered Architect and /or Engineer
New Bui!ding
To be constructed of Kind (fof r undation
Estimated Total cost of improvements S..•�: -.
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
inc 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.
Owner's Name and Address '
G LO S �' 1 . ( Y Street -.&5 2-a2_ tta
Building Inspector
Name and address of licensed contactor
Location and legal description lot to be built on:
Lot EW-r /1c ik 0. lock Subdivision
Street and Number where work is to be done / l g L f 6
peared
Chairman
Merriber
Member .. _ ._..._...._._..._.�...._
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re•in fee of $1.00 will be charged
materials and /or workmanship.
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State work to be done and purpose of building (by floors) Y�� r ( ^( C.
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:Veri
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and for no other purpose.
Remodeling Addition Repair: No. of Stories _
Roof vering
Amount of Permit S.
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..
Member
Member
Member
Disapproved
PLANNING BOARD DATE
E
Notary Public, State of Florida
My Commission Expires �.._
or changes to this application after approval
The un:sersigncd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida \Vorkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup )lenient,
anti 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 f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub�acprtracjors, onfioftq be performed under this
permit, as are licensed by Miami Shores Village.
Reen,uks (Signed)
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-
_ 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 carefull read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are .. r
Permit No.. 2 f 5 .. ».... �.... Date 7 f 1 ..._ k..... »._._ Read, Sworn to and Subscribed before me.
Disapproved S.. . Date
(Signed)
Date
has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
This prOperty described as:
Lot 22 less the West 5 feet and the
West 40 feet of Lot 23, Block 2,
WATERSEDGE,
according to the Plat
thereof, as recorded in
Plat Book 9, Page 141
of the Records of
Dade County, Florida.
":1
.Not valid unless embossed
with Surveyor's Seal.
PROPERTY OF.:
g5; UO'
Grestein. 1184 N.F. 91st Trace,
• A. LAND SURVEY
I hereby certify that the survey repre-
sented hereon meets the minimum
technical standards set forth - by the
Board of land Surveyors pursuant fo
Section 471027, Fla. Statutes. There are
. no encroachments. overlaps, easements
'appearing ory+he..Plat, other -than as
shown h
fit
fla. Reg. Land Surveyu No. i:rWr4.
•
x' /4,9 C7/ 7 - / /5w 2ir-
Miami, Florida.
. 1ANNES and GARCIA,
ENGINEERS -LAND SURVEYORS - LAND PLANNERS -
Office address: 4080 S.W. 84th Avenue, Miami, Florida 33155
Mailing address: P.O. Box 561131, Miami, Florida 33156
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DATE - SCALE DRAWN BY • . DRWG. NO
S 22 -1 1 /�_ � 2' - A76-7, 185 -5572'
THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT k
❑ WITH NO VARIANCES ❑ WITH VARIANCE(S) LISTED IN "RE?.∎ARKS"
NO OTHER DEVIATIONS FROM THE MIAMI SHORES UUILDING AND 7.0IT "'f
ORDINANCES WILL GE PERMITTED, UNLESS SPECIFICALLY LISTED 2 LC. \.
ALL OTHER APPLICABLE STATE AND COUNTY LAWS MUST BE COMPLIED
Authorized Stv'tura Da°
WITH BY ALL PARTIES.
. FIRE DEPARTMENT
PUBLIC WOrf'tS
POLICE Di PAR I PENT
BUILDING DIRECTOR
PLANNING & ZONING BOARD
V1LLALIE, COUNCIL
PRELIMINARY:
REMARKS:
APPROVAL
FINAL:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDi..G COL; AS tiC'T 11
BY MIAMI SHORES VILLAGE IS REOUIRc). T ;?E 1RCdIrE''T, B;!IL) =R &
SUB CONTRACTORS ;.E
:NG REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.